Individual
DR. KHUDR M BURJAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-9000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
061709
GA
207RN0300X
Nephrology Physician
061709
GA
208M00000X
Hospitalist Physician
Primary
61709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061709
LICENSE
GA
05
—
379445205A
—
GA
Enumeration date
07/29/2005
Last updated
10/07/2020
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