MEDICARE: DR. JOHN ANDREW BURKINS MD

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	MD018046E	PA
2	2084P0800X	Psychiatry Physician	018728	ME

General Provider Information

NPI Number	:	1811971864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ANDREW BURKINS MD

Provider Business Mailing Address
First Line	:	601 E BROAD ST
Second Line	:	LEHIGH VALLEY ACT
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6332
Country	:	US
Telephone Number	:	610-882-1355
Fax Number	:	610-882-3181

Provider Business Practice Location Address
First Line	:	601 E BROAD ST
Second Line	:	LEHIGH VALLEY ACT
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6332
Country	:	US
Telephone Number	:	610-882-1355
Fax Number	:	610-882-3181

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	02/10/2015

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