Healthcare Provider Details

I. General information

NPI: 1780659623
Provider Name (Legal Business Name): STEVEN FOSTER BURKE P.A.-C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2409 SPRING ST
COLUMBUS CITY IA
52737-9302
US

IV. Provider business mailing address

2409 SPRING ST
COLUMBUS CITY IA
52737-9302
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-5858
  • Fax: 319-753-2301
Mailing address:
  • Phone: 319-768-5858
  • Fax: 319-753-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001481
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001481
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: