Provider Demographics
NPI:1497712285
Name:DIAL, BURKE HOOD (MD)
Entity Type:Individual
Prefix:DR
First Name:BURKE
Middle Name:HOOD
Last Name:DIAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 402145
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-2145
Mailing Address - Country:US
Mailing Address - Phone:803-434-8323
Mailing Address - Fax:803-434-8326
Practice Address - Street 1:3 RICHLAND MEDICAL PARK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-8323
Practice Address - Fax:803-434-8326
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8345207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC083457Medicaid
D908571955Medicare ID - Type Unspecified
SCD908578946Medicare PIN
SC083457Medicaid
SCD908571955Medicare PIN