Provider Demographics
NPI:1790763795
Name:MCBURNEY, RICHARD OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:OWEN
Last Name:MCBURNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 FAIRWAY SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28638-2440
Mailing Address - Country:US
Mailing Address - Phone:828-728-0900
Mailing Address - Fax:828-728-0868
Practice Address - Street 1:109 FAIRWAY SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NC
Practice Address - Zip Code:28638-2440
Practice Address - Country:US
Practice Address - Phone:828-728-0900
Practice Address - Fax:828-728-0868
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39973207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8955334Medicaid
A72583Medicare UPIN
NC2156165Medicare PIN