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General NPI Number Information
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NPI Number | 1184304115
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Entity Type | Individual
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Provider Name | ROBERT PETER BURDMAN
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Gender | Male
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 16-1412 KOLOA MAOLI RD 9
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City | KURTISTOWN
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State | HI
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Zip | 96760
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Country | US
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Telephone | 808-640-9939
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 109
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City | HILO
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State | HI
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Zip | 96721-0109
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Country | US
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Telephone | 808-640-9939
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | H00383116
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License Number State | HI
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