Healthcare Provider Details

I. General information

NPI: 1164464640
Provider Name (Legal Business Name): GERALD BURMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 POWERS BLVD SUITE 301
PARMA OH
44129-5461
US

IV. Provider business mailing address

6525 POWERS BLVD SUITE 301
PARMA OH
44129-5461
US

V. Phone/Fax

Practice location:
  • Phone: 440-882-0075
  • Fax: 440-882-2092
Mailing address:
  • Phone: 440-882-0075
  • Fax: 440-882-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35-043849
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35-043849
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: