Healthcare Provider Details

I. General information

NPI: 1043393564
Provider Name (Legal Business Name): ROBERT A. BURGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CIVIC CENTER BLVD 3RD FLOOR
PHILADELPHIA PA
19104-5127
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD 3RD FLOOR
PHILADELPHIA PA
19104-5127
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-3318
  • Fax:
Mailing address:
  • Phone: 215-662-3318
  • Fax: 215-349-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD044623L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD044623L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: