Provider Demographics
NPI:1609995901
Name:BURNS, RICHARD D (PA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:BURNS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:935 THORN RUN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MOON TWP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2861
Mailing Address - Country:US
Mailing Address - Phone:412-299-8550
Mailing Address - Fax:412-299-8922
Practice Address - Street 1:935 THORN RUN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MOON TWP
Practice Address - State:PA
Practice Address - Zip Code:15108-2861
Practice Address - Country:US
Practice Address - Phone:412-299-8550
Practice Address - Fax:412-299-8922
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2016-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002211L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA431014Medicare PIN