Healthcare Provider Details

I. General information

NPI: 1073709127
Provider Name (Legal Business Name): BURGER ZAPF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2007
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 WALNUT ST
GREEN COVE SPRINGS FL
32043-3443
US

IV. Provider business mailing address

411 WALNUT ST
GREEN COVE SPRINGS FL
32043-3443
US

V. Phone/Fax

Practice location:
  • Phone: 904-383-0130
  • Fax:
Mailing address:
  • Phone: 904-383-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberD0021888
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: