Provider Demographics
NPI:1467402404
Name:BURCHEL, HAROLD C JR (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:C
Last Name:BURCHEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 SW 78TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3273
Mailing Address - Country:US
Mailing Address - Phone:877-693-5700
Mailing Address - Fax:954-625-6034
Practice Address - Street 1:233 DOCTORS ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-9247
Practice Address - Country:US
Practice Address - Phone:336-372-3214
Practice Address - Fax:336-372-1597
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18395207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8919976Medicaid
NC19976OtherBLUE CROSS
930123583OtherRAILROAD MEDICARE
930123583OtherRAILROAD MEDICARE
NC19976OtherBLUE CROSS