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NPI Code Detail

MEDICARE: DANA BURKHOLDER DO

MEDICARE:   DANA  BURKHOLDER  DO
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
1207Q00000XFamily Medicine PhysicianOS009969LPA

General Provider Information

NPI Number : 1770577900
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA BURKHOLDER DO
Provider Business Mailing Address
First Line : PO BOX 789967
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-9967
Country : US
Telephone Number : 484-622-7395
Fax Number : 484-622-7399
Provider Business Practice Location Address
First Line : 20000 SHANNONDELL DR
Second Line :
City : AUDUBON
State : PA
Zip : 19403
Country : US
Telephone Number : 484-392-4045
Fax Number : 484-392-4049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 11/13/2018

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Directions to “ DANA BURKHOLDER DO” Practice Location

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