John E Buerkert, MD

Individual provider Active NPI Specialist · Columbia, SC

NPI 1831164508 · NPPES record last updated Jan 25, 2012

Key facts

NPI
1831164508
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
15687 (SC)
Practice address
121 Park Central Dr
Suite 200
Columbia, SC 29203-6469
Phone
(803) 252-9907
Fax
(803) 252-9906
NPI assigned
Feb 17, 2006
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
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15687 SC Yes

Addresses

Primary practice location

121 Park Central Dr
Suite 200
Columbia, SC 29203-6469

Mailing address

121 Park Central Dr
Suite 200
Columbia, SC 29203-6469
Phone (803) 252-9907

Other identifiers

IdentifierTypeStateIssuer
TL5689MedicaidSC

Other providers in Columbia, SC

All providers in Columbia, SC · Specialist in South Carolina

Sources for this page

Verify at the official NPI Registry.