Provider Demographics
NPI:1225016553
Name:BURKWALL, PATRICIA J (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:J
Last Name:BURKWALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7001 FOREST AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1726
Mailing Address - Country:US
Mailing Address - Phone:804-282-2655
Mailing Address - Fax:804-282-1793
Practice Address - Street 1:7001 FOREST AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1726
Practice Address - Country:US
Practice Address - Phone:804-282-2655
Practice Address - Fax:804-282-1793
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101233493207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA015245P63OtherMEDICARE PROVIDER NUMBER
VA015245P63OtherMEDICARE PROVIDER NUMBER