Provider Demographics
NPI:1487657730
Name:BURGIN, DAVID R (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:BURGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2644 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:STE 121
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2248
Mailing Address - Country:US
Mailing Address - Phone:225-293-2523
Mailing Address - Fax:225-293-1807
Practice Address - Street 1:100 WINSLOW BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508
Practice Address - Country:US
Practice Address - Phone:337-988-6858
Practice Address - Fax:337-988-6858
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2016-12-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LA015633207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1340111Medicaid
LA5M301Medicare ID - Type Unspecified
LA1340111Medicaid