Burke Keith Fulcher

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · China Grove, NC

NPI 1669919957 · NPPES record last updated Jan 24, 2017

Key facts

NPI
1669919957
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
220 Saw Rd
China Grove, NC 28023-8541
Phone
(704) 223-0084
NPI assigned
Jan 24, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

220 Saw Rd
China Grove, NC 28023-8541

Mailing address

220 Saw Rd
China Grove, NC 28023-8541

Other providers in China Grove, NC

All providers in China Grove, NC · Student in an Organized Health Care Education/Training Program in North Carolina

Sources for this page

Verify at the official NPI Registry.