Doctor Name: | DR. CHARLES M BURKETT |
NPI Number: | 1215970231 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME0045020 |
Business Practice Address: | 1673 Mason Ave Suite # 305 Daytona Beach, FL - 321175515 |
Business Phone Number: | 3862747118 |
Business Fax Number: | 3862746173 |
Mailing Address: | 1673 Mason Ave, Suite # 305 DAYTONA BEACH |
State: | FL |
Postal Code: | 321175515 |
Phone Number: | 3862747118 |
Fax Number: | 3862746173 |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 07/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | ME0045020 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |