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General NPI Number Information
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NPI Number | 1932140001
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Entity Type | Individual
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Provider Name | WILLIAM D BURNHAM MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10160 DORCHESTER RD
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City | SUMMERVILLE
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State | SC
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Zip | 29485-8527
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Country | US
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Telephone | 843-871-7900
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Fax | 843-871-8731
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Provider Business Mailing Address
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Address Line | 4416 FOREST DR 2ND FLOOR
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City | COLUMBIA
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State | SC
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Zip | 29206-3104
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Country | US
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Telephone | 803-782-4278
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Fax | 803-782-3445
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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 | 12071
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License Number State | SC
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