Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | D71767 | MD |
Y | 2084N0400X | Neurologist | 0101255572 | VA |
N | 2084N0400X | Neurologist | D71767 | MD |
NPI | 1326251083 |
---|---|
Provider Name | Sean T Burke |
First Address | Roanoke, VA 24016-4955 |
Second Address | Roanoke, VA 24016-4955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 27/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
054628300 | (05) | MD |