Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 0420010012 | VT |
N | 208000000X | Pediatrician | 0420010012 | VT |
NPI | 1679514111 |
---|---|
Provider Name | Dr. Leah Weyerts Burke |
First Address | Burlington, VT 05401-1417 |
Second Address | Burlington, VT 05401-1417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 04/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E29432 | (02) | |
OVN2253 | (05) | VT |