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Individual

DR. HARRY RUSSELL BURGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12127 B HWY 14 N, STE 5, CEDAR CREST, NM 87008-9461
(505) 281-2460
(505) 281-2463
Mailing address
12127B HWY 14 N, STE 5, CEDAR CREST, NM 87008-9461
(505) 281-2460
(505) 281-2463

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
A122403
NM
208600000X
Surgery Physician
A122403
NM
208D00000X
General Practice Physician
Primary
A-1224-03
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01324331
NM
05
01786342
NM
05
1324331
NM
05
28777841
NM
05
46650024
NM
05
51305879
NM
05
53938577
NM
Enumeration date
05/01/2006
Last updated
01/30/2017
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