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Individual

CHARLES ROBERT BURDETTE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
207 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
(304) 574-2600
Mailing address
207 W MAPLE AVE, FAYETTEVILLE, WV 25840-1413
(304) 574-2600

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ED0220A
WV

Other

Enumeration date
08/11/2011
Last updated
04/10/2026
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