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NPI Code Detail

MEDICARE: CRAIG G BURKHART M.D.

MEDICARE: CRAIG G BURKHART 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
1174400000XSpecialist35042675OH
2207N00000XDermatology Physician35042672OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962405332
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRAIG G BURKHART M.D.
Provider Business Mailing Address
First Line : 5600 MONROE ST
Second Line : STE 106B
City : SYLVANIA
State : OH
Zip : 43560-2728
Country : US
Telephone Number : 419-885-3403
Fax Number : 419-885-3401
Provider Business Practice Location Address
First Line : 5600 MONROE ST
Second Line : STE 106B
City : SYLVANIA
State : OH
Zip : 43560-2728
Country : US
Telephone Number : 419-885-3403
Fax Number : 419-885-3401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 05/20/2011

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Directions to “ CRAIG G BURKHART M.D.” Practice Location

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