Individual
MR. RICHARD BURDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
2401 W BELVEDERE AVE, LAPIDUS CANCER INSTITUTE, BALTIMORE, MD 21215-5216
(410) 601-4604
(410) 601-4601
Mailing address
2401 W BELVEDERE AVE, ATTN: CREDENTIALING, BALTIMORE, MD 21215-5216
(410) 601-5524
(410) 601-8946
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
R122529
MD
363L00000X
Nurse Practitioner
Primary
R122529
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257704600
—
MD
01
—
CA8374
R/R MEDICARE GROUP #
MD
01
—
P00250047
R/R MEDICARE PROVIDER #
MD
Enumeration date
05/08/2006
Last updated
11/21/2007
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