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NPI Code Detail

MEDICARE: EITHNE TERESA BURKE M.D.

MEDICARE: EITHNE TERESA BURKE 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
12085R0202XDiagnostic Radiology Physician97-002-3NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15463480OTHERNCAETNA
2E0193OTHERNCMEDCOST
31040GOTHERNCBLUECROSS BLUESHIELD
4E0194OTHERNCMEDCOST
51827389OTHERNCUNITED HEALTHCARE
6D9074OTHERNCMEDCOST
77356946OTHERNCCIGNA
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568429942
Entity Type Code : Individual
Provider Name (Legal Business Name) : EITHNE TERESA BURKE M.D.
Provider Business Mailing Address
First Line : PO BOX 19368
Second Line :
City : RALEIGH
State : NC
Zip : 27619-9368
Country : US
Telephone Number : 919-787-8221
Fax Number : 919-789-4461
Provider Business Practice Location Address
First Line : 3949 BROWNING PL
Second Line :
City : RALEIGH
State : NC
Zip : 27609-6504
Country : US
Telephone Number : 919-787-8221
Fax Number : 919-789-4461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2006
Last Update Date : 07/08/2007

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Directions to “ EITHNE TERESA BURKE M.D.” Practice Location

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