Provider Demographics
NPI:1619083169
Name:BURDA, VERONICA K (DO)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:K
Last Name:BURDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 DAVIDSON RD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9647
Mailing Address - Country:US
Mailing Address - Phone:614-777-4544
Mailing Address - Fax:614-771-5487
Practice Address - Street 1:4444 DAVIDSON RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9647
Practice Address - Country:US
Practice Address - Phone:614-777-4544
Practice Address - Fax:614-771-5487
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0598447Medicaid
OHE00723Medicare UPIN
OH9312751Medicare ID - Type Unspecified