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Contact Information

JONATHAN H BURDETTE, MD
MEDICAL CENTER BLVD
WINSTON-SALEM, NC27157-0001
 Phone: 336-716-2255
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuroradiology

2085N0700X
 

Vascular & Interventional Radiology

2085R0204X 94 Physician/Interventional Radiology
Indicates primary specialty

NPI Profile & details for JONATHAN H BURDETTE · (Male)

NPI # 1528043940
Status Active
Credentials MD
Entity Individual
Enumeration date 12/08/2005
Last updated 10/08/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 9700877
  • NC Medicaid 891068X
  • SC Medicaid Q00878
  • VA Medicaid 7222629
  • WV Medicaid 2002308000
  • Other 5548719 AETNA
  • Other 1068X BCBS
  • Other 81894 MEDCOST
  • Other 25354 PARTNERS
Hospital affiliation(s)
  • DAVIE MEDICAL CENTER - (Acute Care)
    223 HOSPITAL STREET
    MOCKSVILLE, NC 27028
  • NORTH CAROLINA BAPTIST HOSPITAL - (Acute Care)
    MEDICAL CENTER BOULEVARD
    WINSTON-SALEM, NC 27157
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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