Charles D Burnette
Individual provider Active NPI Speech-Language Pathologist · Bridgton, ME
NPI 1578074837 · NPPES record last updated Oct 13, 2017
Key facts
- NPI
- 1578074837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP2711 (ME)
- Practice address
- 10 Hospital Dr
Bridgton, ME 04009-1148 - Phone
- (207) 647-6000
- Fax
- (207) 647-6065
- NPI assigned
- Oct 13, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP2711 | ME | Yes |
Addresses
Primary practice location
10 Hospital Dr
Bridgton, ME 04009-1148
Mailing address
364 Main St
Lewiston, ME 04240-7029
Other providers in Bridgton, ME
- Bridgton Hospital
- Brock Bridgton LLC
- Brock Health Inc
- Kelsey Brockett
- Jeana Buckland
- Gerald Butler
- Mindy Butler
- Camden Point Inc
- Robert George Carey
- Jeremy Cass
All providers in Bridgton, ME · Speech-Language Pathologist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.