Individual
THOMAS RAY BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00038788
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
22860
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310010
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8354441
—
WA
Enumeration date
10/27/2006
Last updated
07/25/2022
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