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NPI Code Detail

MEDICARE: DR. CHARLES R BURKE MD

MEDICARE: DR. CHARLES R 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
1208000000XPediatrics PhysicianDR.0030840CO

Other Identifiers

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

General Provider Information

NPI Number : 1669461695
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES R BURKE MD
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 6340 BARNES RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80922-2602
Country : US
Telephone Number : 719-522-1134
Fax Number : 719-570-0631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 04/16/2026

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