Provider Demographics
NPI:1194493205
Name:CARDWELL, BURMA GARNER (ORTHOTIST)
Entity type:Individual
Prefix:MRS
First Name:BURMA
Middle Name:GARNER
Last Name:CARDWELL
Suffix:
Gender:F
Credentials:ORTHOTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 FIRST VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-9495
Mailing Address - Country:US
Mailing Address - Phone:910-238-6831
Mailing Address - Fax:
Practice Address - Street 1:5 FIRST VILLAGE DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-9495
Practice Address - Country:US
Practice Address - Phone:910-235-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC000005869677156FX1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1900XEye and Vision Services ProvidersTechnician/TechnologistOrthoptist