Individual
DR. MATTHEW EVAN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2950
CO
152W00000X
Optometrist
628
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87787857
—
NM
Enumeration date
09/10/2008
Last updated
05/02/2013
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