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Individual

SCOTT BURGSTAHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
207 CHURCH ST, SANDPOINT, ID 83864-1342
(208) 263-6876
(208) 263-2033
Mailing address
PO BOX 2153 DEPT 40339, BIRMINGHAM, AL 35287-9387
(706) 271-0100

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M5470
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010003647
PIN
ID
05
003603300
ID
01
54700
PIN
ID
Enumeration date
05/20/2006
Last updated
08/20/2020
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