MEDICARE: DR. BRADLEY GERARD BURKART DPM

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	213E00000X	Podiatrist	747-025	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P01633669	OTHER	WI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528281862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY GERARD BURKART DPM

Provider Business Mailing Address
First Line	:	BLDG 4 2
Second Line	:	30 NORTH 18TH AVENUE
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-3207
Country	:	US
Telephone Number	:	920-743-6668
Fax Number	:

Provider Business Practice Location Address
First Line	:	BLDG 4 2
Second Line	:	30 NORTH 18TH AVENUE
City	:	STURGEON BAY
State	:	WI
Zip	:	54235-3207
Country	:	US
Telephone Number	:	920-743-6668
Fax Number	:

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	06/16/2016

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