Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A145807 | CA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 48607 | AZ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD2018-0175 | NM |
NPI | 1457613150 |
---|---|
Provider Name | Dr. David Ryan Burk |
First Address | Phoenix, AZ 85067-3269 |
Second Address | Glendale, AZ 85307-3018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2012 |
Last Update Date | 26/05/2021 |