Provider Demographics
NPI:1487670204
Name:BURKE, GEORGE W III (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:BURKE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-622-0552
Practice Address - Street 1:1603 SANTA ROSA RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5010
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101020520207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA015974OtherANTHEM HEALTHKEEPERS
VA59271OtherSOUTHERN HEALTH
VA006895400OtherBLACK LUNG
VA2060296OtherAETNA HMO
VA30638OtherCARENET
VA015974OtherANTHEM
VA021781OtherCIGNA
VA4800154OtherUNITED HEALTHCARE
VA81752OtherMAMSI
VA006082122Medicaid
VA110014425OtherRAILROAD MEDICARE
VA557515OtherAETNA
VA006082122Medicaid
VA59271OtherSOUTHERN HEALTH