Individual
DR. JOHN A'HEARN BURDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
924 N HOWE ST, SOUTHPORT, NC 28461-3099
(910) 457-4739
Mailing address
924 N HOWE ST, SOUTHPORT, NC 28461-3099
(304) 610-2517
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
14099
WV
208D00000X
General Practice Physician
Primary
3801
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718056
WV BCBS
WV
05
—
0051084000
—
NC
05
—
0051084000
—
WV
01
—
1053225
WV DWC
WV
Enumeration date
01/04/2006
Last updated
08/28/2024
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