Healthcare Provider Details

I. General information

NPI: 1417934845
Provider Name (Legal Business Name): COREY BURCHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DR DARTMOUTH-HITCHCOCK MEDICAL CENTER
LEBANON NH
03756-1000
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DARTMOUTH-HITCHCOCK MEDICAL CENTER
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-5000
  • Fax: 603-650-8980
Mailing address:
  • Phone: 603-650-5000
  • Fax: 603-650-8980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number12865
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: