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Individual
DAVID BURNETTE
Active
Individual
DAVID BURNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00931
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719576
BLUE CROSS BLUE SHIELD
WV
01
—
3001162
WORKERS COMPENSATION
WV
05
—
7100170150
—
KY
01
—
P00949891
RR MEDICARE
WV
Enumeration date
06/03/2006
Last updated
11/18/2011
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