Healthcare Provider Details
I. General information
NPI: 1316934391
Provider Name (Legal Business Name): ADAM J BURICK D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/04/2005
Last Update Date: 01/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
890 POPLAR CHURCH RD SUITE 210
CAMP HILL PA
17011-2250
US
IV. Provider business mailing address
890 POPLAR CHURCH RD SUITE 210
CAMP HILL PA
17011-2250
US
V. Phone/Fax
- Phone: 717-761-7244
- Fax: 717-761-2055
- Phone: 717-761-7244
- Fax: 717-761-2055
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | OS008695L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: