MEDICARE: DR. STEPHEN C. BURROWS DPM

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	213E00000X	Podiatrist	000690	CT

General Provider Information

NPI Number	:	1053422634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN C. BURROWS DPM

Provider Business Mailing Address
First Line	:	2321 BLACK ROCK TPKE
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3220
Country	:	US
Telephone Number	:	203-372-7445
Fax Number	:	203-372-0506

Provider Business Practice Location Address
First Line	:	2321 BLACK ROCK TPKE
Second Line	:
City	:	FAIRFIELD
State	:	CT
Zip	:	06825-3220
Country	:	US
Telephone Number	:	203-372-7445
Fax Number	:	203-372-0506

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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