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NPI Code Detail

MEDICARE: WYLIE GILMAN BURKE

MEDICARE: WYLIE GILMAN BURKE
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
1207R00000XInternal Medicine PhysicianMD00017576WA
2207SG0201XClinical Genetics (M.D.) PhysicianMD00017576WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21778OTHERINTERNAL ID-MOTOR VEHICLE ID

General Provider Information

NPI Number : 1427133222
Entity Type Code : Individual
Provider Name (Legal Business Name) : WYLIE GILMAN BURKE
Provider Business Mailing Address
First Line : PO BOX 50095
Second Line :
City : SEATTLE
State : WA
Zip : 98145-5095
Country : US
Telephone Number : 206-543-6420
Fax Number :
Provider Business Practice Location Address
First Line : UNIVERSITY OF WASHINGTON MEDICAL CTR
Second Line : 1959 NE PACIFIC ST
City : SEATTLE
State : WA
Zip : 98195-6127
Country : US
Telephone Number : 206-616-2135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 12/06/2013

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