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NPI Code Detail

MEDICARE: MR. NATHAN WILLIAM BURGER IDC

MEDICARE:  MR. NATHAN WILLIAM BURGER  IDC
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
11710I1002XIndependent Duty Corpsman

General Provider Information

NPI Number : 1679844229
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NATHAN WILLIAM BURGER IDC
Provider Business Mailing Address
First Line : USS CARL VINSON
Second Line : CVN 70
City : FPO
State : AP
Zip : 96629-2840
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : USS CARL VINSON
Second Line : CVN 70
City : FPO
State : AP
Zip : 96629-2840
Country : US
Telephone Number : 619-545-7882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2012
Last Update Date : 01/13/2012

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Directions to “ MR. NATHAN WILLIAM BURGER IDC” Practice Location

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