Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD020937E | PA |
N | 2086S0129X | Vascular Surgeon | MD020937E | PA |
NPI | 1255363362 |
---|---|
Provider Name | Alan M Burke |
First Address | Philadelphia, PA 19115-4659 |
Second Address | Philadelphia, PA 19115-4659 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 08/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D75363 | (02) | PA |