Provider Demographics
NPI:1366459869
Name:BURKE, SHEILA A (MD)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:BURKE
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 1:2841 DEBARR RD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2932
Mailing Address - Country:US
Mailing Address - Phone:907-743-1435
Mailing Address - Fax:907-743-1400
Practice Address - Street 1:2841 DEBARR RD
Practice Address - Street 2:SUITE 40
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2932
Practice Address - Country:US
Practice Address - Phone:907-743-1435
Practice Address - Fax:907-743-1400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1795Medicaid
AKAB1290179OtherDEA
AKAB1290179OtherDEA
AKK OOWCKDWCMedicare PIN
AKOOWCKDWCMedicare ID - Type Unspecified