Provider Demographics
NPI:1841378296
Name:BURLINGTON PEDIATRICS PA
Entity type:Organization
Organization Name:BURLINGTON PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:MERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-228-8316
Mailing Address - Street 1:530 W WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217
Mailing Address - Country:US
Mailing Address - Phone:336-228-8316
Mailing Address - Fax:336-227-9750
Practice Address - Street 1:530 W WEBB AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-3706
Practice Address - Country:US
Practice Address - Phone:336-228-8316
Practice Address - Fax:336-227-9750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty