Doctor Name: | DR. CHARLES V BURTON |
NPI Number: | 1902910284 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 21358 |
Business Practice Address: | 514 Saint Peter St Ste 220 Saint Paul, MN - 551021020 |
Business Phone Number: | 6512878781 |
Business Fax Number: | 6512878782 |
Mailing Address: | 514 Saint Peter St Ste 220, SAINT PAUL |
State: | MN |
Postal Code: | 551021020 |
Phone Number: | 6512878781 |
Fax Number: | 6512878782 |
NPI Enumeration Date: | 08/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 21358 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |