Healthcare Provider Details
I. General information
NPI: 1275739765
Provider Name (Legal Business Name): ANDREW GARRETT BURKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/22/2007
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1746 COLE BLVD STE 100
LAKEWOOD CO
80401-3208
US
IV. Provider business mailing address
1746 COLE BLVD STE 100
LAKEWOOD CO
80401-3208
US
V. Phone/Fax
- Phone: 303-914-8800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085D0003X |
| Taxonomy | Diagnostic Neuroimaging (Radiology) Physician |
| License Number | MD157964 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | CDRH.0073684 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: