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General NPI Number Information
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NPI Number | 1659374882
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Entity Type | Individual
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Provider Name | DAVID A BURACK MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 744 ARDEN LN SUITE 225
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City | ROCK HILL
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State | SC
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Zip | 29732-2984
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Country | US
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Telephone | 803-329-1660
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Fax | 803-329-4118
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Provider Business Mailing Address
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Address Line | 744 ARDEN LN SUITE 225
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City | ROCK HILL
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State | SC
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Zip | 29732-2984
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Country | US
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Telephone | 803-329-1660
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Fax | 803-329-4118
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 14896
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 39768
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 14896
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License Number State | SC
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