Provider Demographics
NPI:1093854804
Name:BURKE, STEVEN LAWSON (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LAWSON
Last Name:BURKE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 S MARYLAND PKWY
Mailing Address - Street 2:SUITE A2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1699
Mailing Address - Country:US
Mailing Address - Phone:702-735-0000
Mailing Address - Fax:702-735-6906
Practice Address - Street 1:2650 S MARYLAND PKWY
Practice Address - Street 2:SUITE A2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1699
Practice Address - Country:US
Practice Address - Phone:702-735-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3602150Medicaid
NVVWJBCX01Medicare PIN
NVVWJBCXMedicare PIN
NVU16843Medicare UPIN