Provider Demographics
NPI:1639368244
Name:ANISE T BURKI INC
Entity Type:Organization
Organization Name:ANISE T BURKI INC
Other - Org Name:ANISE T BURKI INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANISE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BURKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-273-6363
Mailing Address - Street 1:7457 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-2517
Mailing Address - Country:US
Mailing Address - Phone:317-273-6363
Mailing Address - Fax:317-273-6358
Practice Address - Street 1:7457 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-2517
Practice Address - Country:US
Practice Address - Phone:317-273-6363
Practice Address - Fax:317-273-6358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN219310AMedicare PIN
INE14741Medicare UPIN