Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 50013 | CO |
N | 111NI0900X | Internist | 50013 | CO |
Y | 207R00000X | Internist | MD463978 | PA |
Y | 111NI0900X | Internist | MD463978 | PA |
NPI | 1003074790 |
---|---|
Provider Name | Dr. Robert Burke |
First Address | Philadelphia, PA 19104-2640 |
Second Address | Philadelphia, PA 19104-2640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 01/10/2020 |