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General NPI Number Information
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NPI Number | 1942294244
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Entity Type | Organization
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Legal Business Name | BURLINGTON PEDIATRIC ASSOCIATION, P.C.
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Dates
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Enumeration Date | 09/01/2005
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 1223 S GEAR AVE SUITE 108
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1685
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Country | US
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Telephone | 319-753-5177
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Fax | 319-753-0893
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Provider Business Mailing Address
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Address Line | 1223 S GEAR AVE SUITE 108
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1685
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Country | US
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Telephone | 319-753-5177
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Fax | 319-753-0893
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DONALD R MCCABE
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Credential | M.D.
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Telephone | 319-753-5177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 18676
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License Number State | IA
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