Basic Information
| Provider Information | |||||||||
| NPI: | 1922391515 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURGARD | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1220 SHEYENNE ST | ||||||||
| Address2: | |||||||||
| City: | WEST FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 580782637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012344445 | ||||||||
| FaxNumber: | 7012344456 | ||||||||
| Practice Location | |||||||||
| Address1: | 1220 SHEYENNE ST | ||||||||
| Address2: | |||||||||
| City: | WEST FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 580782637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7012344445 | ||||||||
| FaxNumber: | 7012344456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2011 | ||||||||
| LastUpdateDate: | 04/23/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 13201 | ND | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.