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General NPI Number Information
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NPI Number | 1497194732
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Entity Type | Individual
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Provider Name | MARIANNE LOUISE BURDA M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 404 CLOVERDALE DR
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City | WEXFORD
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State | PA
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Zip | 15090-8359
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Country | US
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Telephone | 724-933-0265
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Fax | 724-933-0265
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Provider Business Mailing Address
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Address Line | 404 CLOVERDALE DR
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City | WEXFORD
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State | PA
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Zip | 15090-8359
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Country | US
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Telephone | 724-933-0265
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Fax | 724-933-0265
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174V00000X
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Taxonomy Name | Clinical Ethicist
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License Number | MD-040273-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD-040273-L
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License Number State | PA
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