MEDICARE: DR. COLLIN MICHAEL BURKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.155307	OH

General Provider Information

NPI Number	:	1043899214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLLIN MICHAEL BURKE MD

Provider Business Mailing Address
First Line	:	2139 AUBURN AVE STE 2170
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2139 AUBURN AVE
Second Line	:	SUITE 2170
City	:	CINCINNATI
State	:	OH
Zip	:	45219
Country	:	US
Telephone Number	:	513-585-4079
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2021
Last Update Date	:	06/08/2026

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