Provider Demographics
NPI:1942315957
Name:BURZON, EDWARD C (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:C
Last Name:BURZON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 PILLSBURY ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-3556
Mailing Address - Country:US
Mailing Address - Phone:603-224-4776
Mailing Address - Fax:603-228-2113
Practice Address - Street 1:1 PILLSBURY ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3556
Practice Address - Country:US
Practice Address - Phone:603-224-4776
Practice Address - Fax:603-228-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2015-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH10482207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30200091Medicaid
NH30200091Medicaid
NHRE5075Medicare ID - Type Unspecified