Provider Demographics
NPI:1497818264
Name:BURKS, ARVIL WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:ARVIL
Middle Name:WESLEY
Last Name:BURKS
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 1:4032 BONDURANT HL
Mailing Address - Street 2:CB #7000
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7000
Mailing Address - Country:US
Mailing Address - Phone:919-966-4161
Mailing Address - Fax:
Practice Address - Street 1:4032 BONDURANT HL CB #7000
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7000
Practice Address - Country:US
Practice Address - Phone:919-966-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003-00568207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89134H7Medicaid
C67910Medicare UPIN
NC89134H7Medicaid