MEDICARE: RYAN BURGER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171000000X	Military Health Care Provider
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1043998289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN BURGER PA-C

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVE
Second Line	:
City	:	FORT LIBERTY
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

Provider Business Practice Location Address
First Line	:	1722 TAGATAY C
Second Line	:
City	:	FORT LIBERTY
State	:	NC
Zip	:	28307
Country	:	US
Telephone Number	:	651-788-1553
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2023
Last Update Date	:	11/12/2024

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Directions to “ RYAN BURGER PA-C” Practice Location

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