| Doctor Name: | MR. CHARLES CLIFTON BURROUGHS |
| NPI Number: | 1285621201 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | 0024164796 |
| Business Practice Address: | Naval Hospital Guam Farenholt Ave Bldg K-1 Agana Heights, GU - 96910 |
| Business Phone Number: | 6716449054 |
| Business Fax Number: | |
| Mailing Address: | 999 S Marine Dr, Alupang Beach Tower #401 TAMUNING |
| State: | GU |
| Postal Code: | 969133415 |
| Phone Number: | 6716499666 |
| Fax Number: | |
| NPI Enumeration Date: | 10/04/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024164796 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |