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Individual

DR. ILYAS BURNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-6544
(573) 884-5226
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2003028521
MO
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2003028521
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
208367110
MO
01
214221
BCBS
MO
01
723806
HEALTHLINK
MO
Enumeration date
08/11/2006
Last updated
11/20/2007
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