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Individual

EDWARD M BURDOCK

Active
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Individual

EDWARD M BURDOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC CCSP

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
A06120
IA
111NS0005X
Sports Physician Chiropractor
Primary
A06120
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0179408
IA
01
45770
WELLMARK BLUE CROSS BLUE
IA
Enumeration date
03/04/2007
Last updated
03/26/2009
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If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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