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General NPI Number Information
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NPI Number | 1235199399
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Entity Type | Individual
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Provider Name | JOSEPH ALAN BURMEISTER IDC
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | NAVAL HOSPITAL GREAT LAKES
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City | GREAT LAKES
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State | IL
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Zip | 60088-5230
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Country | US
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Telephone | 847-688-6661
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Fax | 847-688-2722
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Provider Business Mailing Address
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Address Line | 7024 95TH AVE
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City | KENOSHA
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State | WI
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Zip | 53142-7613
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Country | US
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Telephone |
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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 | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State |
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