Provider Demographics
NPI:1386648004
Name:BURGER, MAX (MD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:BURGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 ROUTE 206
Mailing Address - Street 2:STE 10
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-3558
Mailing Address - Country:US
Mailing Address - Phone:609-801-0300
Mailing Address - Fax:609-801-0399
Practice Address - Street 1:1805 ROUTE 206
Practice Address - Street 2:RED LION PLAZA, SUITE 10
Practice Address - City:SOUTHAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08088-3558
Practice Address - Country:US
Practice Address - Phone:609-801-0300
Practice Address - Fax:609-801-0399
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2014-03-23
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
NJMA034377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJBU631937Medicare UPIN