Healthcare Provider Details

I. General information

NPI: 1801829809
Provider Name (Legal Business Name): BURKE E CHEGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 W CARMEL DR STE 100
CARMEL IN
46032-5802
US

IV. Provider business mailing address

735 W CARMEL DR STE 100
CARMEL IN
46032-5802
US

V. Phone/Fax

Practice location:
  • Phone: 317-818-5438
  • Fax: 317-818-5444
Mailing address:
  • Phone: 317-818-5438
  • Fax: 317-818-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number01061854A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01061854A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: