Provider Demographics
NPI:1972547628
Name:BURMAN, HARRISON EMORY GUY (MD)
Entity type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:EMORY GUY
Last Name:BURMAN
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 1:1115 SE 164TH AVE DEPT 358
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8004
Mailing Address - Country:US
Mailing Address - Phone:360-729-1462
Mailing Address - Fax:360-729-3104
Practice Address - Street 1:3100 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901
Practice Address - Country:US
Practice Address - Phone:907-225-7346
Practice Address - Fax:907-228-8325
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15433208600000X
AK139493208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02489903Medicaid
AKMD8300Medicaid
NH32001066Medicaid
AKMD8300Medicaid
NH32001066Medicaid
H51946Medicare UPIN
AKK161064Medicare PIN