Provider Demographics
NPI:1164406286
Name:BURLINGAME, JANET M (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:BURLINGAME
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 1:970 N KALAHEO AVE STE A108
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1868
Mailing Address - Country:US
Mailing Address - Phone:808-762-1996
Mailing Address - Fax:808-441-0022
Practice Address - Street 1:970 N KALAHEO AVE STE A108
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1868
Practice Address - Country:US
Practice Address - Phone:808-772-1767
Practice Address - Fax:808-441-0022
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD13380207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI572330Medicaid
100697Medicare ID - Type Unspecified
HI572330Medicaid