Provider Demographics
NPI:1134310311
Name:BURZINSKI, SHILOE SOUZA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHILOE
Middle Name:SOUZA
Last Name:BURZINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 HERRICK ST STE 2004
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-2757
Mailing Address - Country:US
Mailing Address - Phone:978-927-4800
Mailing Address - Fax:978-777-4792
Practice Address - Street 1:83 HERRICK ST STE 2004
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-2757
Practice Address - Country:US
Practice Address - Phone:978-927-4800
Practice Address - Fax:978-777-4792
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2023-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1108207V00000X
MA246863207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4656869471OtherMYUTMB 4656869471