Individual
JAMES T BURDETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9853
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118822
—
IL
05
—
100500798
—
NV
01
—
207988
GROUP MED
IL
01
—
CE9335
RR MEDICARE GRP
IL
01
—
P00396911
RR MEDICARE
—
Enumeration date
01/23/2006
Last updated
08/22/2019
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