Provider Demographics
NPI:1033215140
Name:BURD, DEANA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DEANA
Middle Name:MARIE
Last Name:BURD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CHRISTIANA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1653
Mailing Address - Country:US
Mailing Address - Phone:302-731-0869
Mailing Address - Fax:302-292-0669
Practice Address - Street 1:300 CHRISTIANA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1653
Practice Address - Country:US
Practice Address - Phone:302-731-0869
Practice Address - Fax:302-292-0669
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU81603Medicare UPIN
DE490620Medicare ID - Type Unspecified