Individual
DR. KENNETH M BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3715 DAUPHIN ST STE 4400, MOBILE, AL 36608-1727
(251) 607-9797
Mailing address
6701 AIRPORT BLVD, SUITE D-330, MOBILE, AL 36608-6705
(251) 607-9797
(251) 607-9761
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
23415
AL
207RC0000X
Cardiovascular Disease Physician
00023415
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000096629
—
AL
05
—
0122395
—
MS
01
—
510-96629
BLUE CROSS BLUE SHIELD
AL
Enumeration date
06/07/2006
Last updated
07/21/2022
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