Healthcare Provider Details

I. General information

NPI: 1447238175
Provider Name (Legal Business Name): THOMAS JOHN BURKE MD MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED ARMY MEDICAL CENTER 6900 GEORGIA AVE NW
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

4872 CHEVY CHASE BLVD
CHEVY CHASE MD
20815-5340
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-6061
  • Fax: 202-782-8379
Mailing address:
  • Phone: 301-652-6559
  • Fax: 301-652-6559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101053704
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: