Individual
DAVID WAYNE BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MBA
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7311
Mailing address
75 REMIT DRIVE, LOCKBOX 1876, CHICAGO, IL 60675-1876
(866) 916-5259
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-090895
IL
207P00000X
Emergency Medicine Physician
107364
MO
207P00000X
Emergency Medicine Physician
25.067203
OH
207P00000X
Emergency Medicine Physician
2666
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036090895
—
IL
05
—
036090895-3
—
IL
05
—
208063727
—
MO
Enumeration date
07/17/2006
Last updated
05/13/2009
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