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NPI Code Detail

MEDICARE: MR. ROBERT D BURNSIDE CST/CFA

MEDICARE:  MR. ROBERT D BURNSIDE  CST/CFA
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
1246ZC0007XSurgical Assistant92233OH

General Provider Information

NPI Number : 1497921597
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT D BURNSIDE CST/CFA
Provider Business Mailing Address
First Line : 61 SCHENLEY AVE
Second Line :
City : STRUTHERS
State : OH
Zip : 44471-2144
Country : US
Telephone Number : 330-755-6992
Fax Number : 330-747-0491
Provider Business Practice Location Address
First Line : 540 PARMALEE AVE STE 410
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44510-1605
Country : US
Telephone Number : 330-747-1106
Fax Number : 330-747-0491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2008
Last Update Date : 05/08/2008

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Directions to “ MR. ROBERT D BURNSIDE CST/CFA” Practice Location

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