Individual
JOHN STANLEY BURNHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1716 N CROSS ST, DOVER, OH 44622-1043
(330) 364-8868
(330) 364-4732
Mailing address
110 DUBLIN DRIVE, SUITE A, DOVER, OH 44622
(330) 364-8868
(330) 364-4732
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-05-2279B
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0661412
—
OH
Enumeration date
11/14/2005
Last updated
11/07/2016
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