Individual
DR. ROBERT J BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, STE 300, COEUR D ALENE, ID 83814-6051
(208) 666-2552
(208) 666-2556
Mailing address
122 W 7TH AVE, STE 110, SPOKANE, WA 99204-2349
(509) 456-0262
(509) 462-5059
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
M-8773
ID
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD00036338
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11104691
MEDICARE PTAN
ID
05
—
806593702
—
ID
05
—
8357345
—
WA
01
—
G8870910
MEDICARE PTAN
WA
01
—
G8878163
MEDICARE PTAN
WA
Enumeration date
07/13/2005
Last updated
10/01/2020
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