MEDICARE: DR. THOMAS JOHN BURKE MD MPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	0101053704	VA

General Provider Information

NPI Number	:	1447238175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JOHN BURKE MD MPH

Provider Business Mailing Address
First Line	:	4872 CHEVY CHASE BLVD
Second Line	:
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-5340
Country	:	US
Telephone Number	:	301-652-6559
Fax Number	:	301-652-6559

Provider Business Practice Location Address
First Line	:	WALTER REED ARMY MEDICAL CENTER
Second Line	:	6900 GEORGIA AVE NW
City	:	WASHINGTON
State	:	DC
Zip	:	20307-0001
Country	:	US
Telephone Number	:	202-782-6061
Fax Number	:	202-782-8379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	07/08/2007

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