Provider Demographics
NPI:1164402475
Name:BURGET, DEAN EDWIN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:EDWIN
Last Name:BURGET
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1436
Mailing Address - Country:US
Mailing Address - Phone:610-750-7891
Mailing Address - Fax:610-750-7896
Practice Address - Street 1:3317 PENN AVE
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609
Practice Address - Country:US
Practice Address - Phone:610-750-7891
Practice Address - Fax:610-750-7896
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008704E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942442553OtherNPI RDA
PA150588OtherMEDICARE RDA
PADP7691OtherRAILROAD MEDICARE RDA
PA150588OtherMEDICARE RDA
1942442553OtherNPI RDA
PA429860ZDH3Medicare PIN