Provider Demographics
NPI:1548244692
Name:BURCH, DAVID MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARSHALL
Last Name:BURCH
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 1:2484 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6522
Mailing Address - Country:US
Mailing Address - Phone:520-888-2121
Mailing Address - Fax:520-888-4850
Practice Address - Street 1:2484 E RIVER RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6522
Practice Address - Country:US
Practice Address - Phone:520-888-2121
Practice Address - Fax:520-888-4850
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33153-020207ZD0900X, 207ZP0102X
AZ44849207ZD0900X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ44849OtherSTATE LICENSE