MEDICARE: DR. LEEMORE M BURKE M.D.

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	207V00000X	Obstetrics & Gynecology Physician	0101230604	VA

General Provider Information

NPI Number	:	1437141892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEEMORE M BURKE M.D.

Provider Business Mailing Address
First Line	:	7605 FOREST AVE
Second Line	:	SUITE 411
City	:	RICHMOND
State	:	VA
Zip	:	23229-4938
Country	:	US
Telephone Number	:	804-285-8806
Fax Number	:	804-288-6079

Provider Business Practice Location Address
First Line	:	7605 FOREST AVE
Second Line	:	SUITE 411
City	:	RICHMOND
State	:	VA
Zip	:	23229-4938
Country	:	US
Telephone Number	:	804-285-8806
Fax Number	:	804-288-6079

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	02/09/2022

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