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NPI Code Detail

MEDICARE: DR. NICHOLAS C VAN BUREN M.D.

MEDICARE:  DR. NICHOLAS C VAN BUREN  M.D.
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
1207Y00000XOtolaryngology PhysicianMD.MD.60632816WA

General Provider Information

NPI Number : 1588955785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLAS C VAN BUREN M.D.
Provider Business Mailing Address
First Line : 1424 N MCDONALD RD STE 101
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99216-6017
Country : US
Telephone Number : 508-928-7272
Fax Number :
Provider Business Practice Location Address
First Line : 1424 N MCDONALD RD STE 101
Second Line :
City : SPOKANE VALLEY
State : WA
Zip : 99216-6017
Country : US
Telephone Number : 508-928-7272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2011
Last Update Date : 03/31/2022

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Directions to “ DR. NICHOLAS C VAN BUREN M.D.” Practice Location

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