Provider Demographics
NPI:1376649962
Name:BURKE, MICHAEL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5454 YORKTOWNE DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-5317
Mailing Address - Country:US
Mailing Address - Phone:770-991-6044
Mailing Address - Fax:770-991-3843
Practice Address - Street 1:730 PEACHTREE ST NE STE 570
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1244
Practice Address - Country:US
Practice Address - Phone:404-491-1941
Practice Address - Fax:404-393-9624
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2023-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0547982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G54966002Medicare UPIN