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Individual

MARCUS R BURHANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
205 E PALMER RD, BELLEFONTAINE, OH 43311
(937) 592-4015
(937) 292-7148
Mailing address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 592-4015
(937) 292-7148

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRNCRNA07987
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2520927
OH
Enumeration date
10/26/2006
Last updated
11/30/2022
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