Provider Demographics
NPI:1508858044
Name:BURNS, GEORGE E (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:E
Last Name:BURNS
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 1:1122 DRUID RD E
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4100
Mailing Address - Country:US
Mailing Address - Phone:727-461-2282
Mailing Address - Fax:
Practice Address - Street 1:1122 DRUID RD E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4100
Practice Address - Country:US
Practice Address - Phone:727-461-2282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0032383207ND0900X
FL0032383207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0305003OtherUNITED HEALTHCARE
FL77445OtherMEDICARE GROUP PROV.
FL044851600Medicaid
FL2147510OtherAETNA
FL73270ZOtherBCBS PERFORMING PROVIDER
FL0305003OtherUNITED HEALTHCARE