Provider Demographics
NPI:1417702572
Name:BURNHAM, NATHANIEL JAMES (DO)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:JAMES
Last Name:BURNHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 S WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-8838
Mailing Address - Country:US
Mailing Address - Phone:434-439-0138
Mailing Address - Fax:
Practice Address - Street 1:4000 JOHNSON RD APT 2
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2364
Practice Address - Country:US
Practice Address - Phone:434-439-0138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program