Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD458138 | PA |
NPI | 1043500341 |
---|---|
Provider Name | Dr. Gregory Michael Burkman |
First Address | Hershey, PA 17033 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2011 |
Last Update Date | 12/08/2021 |