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NPI Code Detail

MEDICARE: MATTHEW JOSEPH BURKE MD, PHD

MEDICARE: MATTHEW JOSEPH BURKE MD, PHD
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
12084P0800XPsychiatry Physician37469AZ
22084P0800XPsychiatry Physician39364CO

General Provider Information

NPI Number : 1114916509
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW JOSEPH BURKE MD, PHD
Provider Business Mailing Address
First Line : 1650 COCHRANE CIR UNIT MEDDAC
Second Line :
City : FORT CARSON
State : CO
Zip : 80913-4604
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1650 COCHRANE CIR UNIT MEDDAC
Second Line :
City : FORT CARSON
State : CO
Zip : 80913-4604
Country : US
Telephone Number : 719-503-7713
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 01/31/2025

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