Provider Demographics
NPI:1508825506
Name:BURRI, STUART H (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:H
Last Name:BURRI
Suffix:
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 1:200 QUEENS RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-3252
Mailing Address - Country:US
Mailing Address - Phone:704-333-7376
Mailing Address - Fax:704-333-3397
Practice Address - Street 1:1021 MOREHEAD MEDICAL DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2839
Practice Address - Country:US
Practice Address - Phone:704-355-2272
Practice Address - Fax:704-355-1865
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000001922085R0001X
SC207282085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC126G7OtherBLUE CROSS
2124574OtherUNITED HEALTHCARE
NC5002463006OtherCIGNA
NC89126G7Medicaid
36729OtherPARTNERS
NC99466OtherMEDCOST
SCN00194Medicaid
NC99466OtherMEDCOST
NC2280190EMedicare ID - Type UnspecifiedMATTHEWS RAD ONC CTR
SC920005530Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NC2280190AMedicare ID - Type Unspecified
2124574OtherUNITED HEALTHCARE
NCH11229Medicare UPIN
SCN00194Medicaid