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General NPI Number Information
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NPI Number | 1669402129
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Entity Type | Individual
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Provider Name | CHARLES S BURGER MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 700 MT HOPE AVE SUITE 650 NORUMBEGA EVERGREEN WOODS
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City | BANGOR
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State | ME
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Zip | 04401-5691
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Country | US
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Telephone | 207-945-5048
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Fax | 207-992-9515
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Provider Business Mailing Address
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Address Line | PO BOX 9746
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City | PORTLAND
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State | ME
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Zip | 04104-5040
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Country | US
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Telephone | 207-791-3888
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Fax | 207-828-7850
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD6644
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License Number State | ME
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