Healthcare Provider Details

I. General information

NPI: 1407240955
Provider Name (Legal Business Name): MATTHEW BURDETTE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3130 STATE HWY RTE 6
WELLFLEET MA
02667-7402
US

IV. Provider business mailing address

PO BOX 598
HARWICH PORT MA
02646-0598
US

V. Phone/Fax

Practice location:
  • Phone: 508-349-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number274051
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: