Provider Demographics
NPI:1255332417
Name:BURNS, PATRICK RAYMOND (DPM)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:RAYMOND
Last Name:BURNS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 LOCUST ST STE 350
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5131
Mailing Address - Country:US
Mailing Address - Phone:412-232-9080
Mailing Address - Fax:412-232-9075
Practice Address - Street 1:1515 LOCUST ST STE 350
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5131
Practice Address - Country:US
Practice Address - Phone:412-232-9080
Practice Address - Fax:412-232-9075
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC-004689-L213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008281600001Medicaid
PAU85670Medicare UPIN
PA049074Medicare ID - Type Unspecified