Mark Richard Burt MD

NPI 1619141827 - Anesthesiology - 207L00000X

NPI Details
NPI 1619141827
Gender Male
Enumeration Date 04/17/2008
Last Updated 05/15/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
201 RIDGE ST
SUITE 102
COUNCIL BLUFFS IA, 51503-4643, US
Phone (712) 322-5565
Fax (712) 322-5566
Business Location
PO BOX 1988
MEDICAL ANESTHESIA ASSOCIATES PC
COUNCIL BLUFFS IA, 51502-1988, US
Phone (712) 322-5565
Fax (712) 322-5566
Toxanomy
Taxonomy Code 207L00000X
License State Nebraska
License Number 40447
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According to our database, Mark Richard Burt MD NPI is 1619141827, taxonomy code is 207L00000X and license number is 40447, license state is located at Nebraska. Mark Richard Burt MD physically located at 201 Ridge St, Council Bluffs IA, 51503-4643. NPI Number Mark Richard Burt MD has the Individual type.

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1619141827 NPI number is provided on an as is basis without warranty of any kind. 1619141827 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Richard Burt MD are for informational purposes only.