MEDICARE: BURGAW MEDICAL CENTER

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1568781862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BURGAW MEDICAL CENTER

Provider Business Mailing Address
First Line	:	311 S MCNEIL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5015
Country	:	US
Telephone Number	:	910-259-3377
Fax Number	:	910-259-3013

Provider Business Practice Location Address
First Line	:	311 S MCNEIL ST
Second Line	:
City	:	BURGAW
State	:	NC
Zip	:	28425-5015
Country	:	US
Telephone Number	:	910-259-3377
Fax Number	:	910-259-3013

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. NOOTAN SINGH
Credential	:
Telephone Number	:	910-259-3377

Provider Enumeration Date	:	05/26/2010
Last Update Date	:	12/14/2015

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Directions to “BURGAW MEDICAL CENTER ” Practice Location

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