Individual
DR. RANDALL D BURR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1618 S. MILLENNIUM WAY, SUITE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Mailing address
1618 S. MILLENNIUM WAY, SUITE 100, MERIDIAN, ID 83642-6457
(208) 884-3376
(208) 884-0858
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M5986
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003412200
—
ID
Enumeration date
06/27/2006
Last updated
08/29/2019
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