Healthcare Provider Details

I. General information

NPI: 1841458148
Provider Name (Legal Business Name): SIOBHAN KATHERINE BURKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 14TH ST NW
WASHINGTON DC
20009-6865
US

IV. Provider business mailing address

1220 12TH ST SE STE 120
WASHINGTON DC
20003-3733
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-4300
  • Fax: 202-548-8600
Mailing address:
  • Phone: 202-715-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA109580
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD040504
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: