MEDICARE: DR. DAVID MARSHALL BURCH M.D.

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	207ZD0900X	Dermatopathology (Pathology) Physician	33153-020	WI
2	207ZD0900X	Dermatopathology (Pathology) Physician	44849	AZ
3	207ZP0101X	Anatomic Pathology Physician	44849	AZ
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	33153-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	44849	OTHER	AZ	STATE LICENSE

General Provider Information

NPI Number	:	1548244692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MARSHALL BURCH M.D.

Provider Business Mailing Address
First Line	:	2484 E RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-6522
Country	:	US
Telephone Number	:	520-888-2121
Fax Number	:	520-888-4850

Provider Business Practice Location Address
First Line	:	2484 E RIVER RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-6522
Country	:	US
Telephone Number	:	520-888-2121
Fax Number	:	520-888-4850

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	01/08/2021

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Directions to “ DR. DAVID MARSHALL BURCH M.D.” Practice Location

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