MEDICARE: JAMES M BURY MD

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	207Q00000X	Family Medicine Physician	42528	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467486514
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M BURY MD

Provider Business Mailing Address
First Line	:	7137 236TH AVE STE 103
Second Line	:
City	:	SALEM
State	:	WI
Zip	:	53168-8975
Country	:	US
Telephone Number	:	262-843-4422
Fax Number	:	262-843-1166

Provider Business Practice Location Address
First Line	:	7137 236TH AVE STE 103
Second Line	:
City	:	SALEM
State	:	WI
Zip	:	53168-8975
Country	:	US
Telephone Number	:	262-843-4422
Fax Number	:	262-843-1166

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	11/20/2009

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