Individual
SAMUEL O BURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1139 E HIGH ST STE 203, CHARLOTTESVILLE, VA 22902-4849
(434) 817-8484
(434) 817-8490
Mailing address
7746 S 164TH DR, GOODYEAR, AZ 85338-5836
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024190708
VA
367500000X
Certified Registered Nurse Anesthetist
076895-21
NH
367500000X
Certified Registered Nurse Anesthetist
240773
AZ
Other
Enumeration date
12/06/2017
Last updated
04/25/2025
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