Healthcare Provider Details

I. General information

NPI: 1992753735
Provider Name (Legal Business Name): BURWELL FAMILY MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 764 PLZ
DUNCANSVILLE PA
16635-8051
US

IV. Provider business mailing address

3 764 PLZ
DUNCANSVILLE PA
16635-8051
US

V. Phone/Fax

Practice location:
  • Phone: 814-695-3305
  • Fax:
Mailing address:
  • Phone: 814-695-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD424989
License Number StatePA

VIII. Authorized Official

Name: MR. DAN BURWELL II
Title or Position: OFFICE MANAGER
Credential:
Phone: 814-695-3305