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1750660502
CHARLES ROBERT BURDETTE
RAINELLE, WV
NPI
1750660502
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: WV ED0220A)
Enumeration Date
2011-08-11
Last Update Date
2020-09-17
Business Address
CHARLES ROBERT BURDETTE D.O.
1515 SNOWDEN RD
RAINELLE, WV 25962-6585
Phone number: 304-438-5614
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Mailing Address
CHARLES ROBERT BURDETTE D.O.
5495 MAPLE LN
FAYETTEVILLE, WV 25840-6872
Phone number: 304-574-0120
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