Provider Demographics
NPI:1659364107
Name:BURKE, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:BURKE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4907
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50306-4907
Mailing Address - Country:US
Mailing Address - Phone:515-241-5785
Mailing Address - Fax:515-241-5785
Practice Address - Street 1:1221 PLEASANT ST
Practice Address - Street 2:STE 400
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1423
Practice Address - Country:US
Practice Address - Phone:515-241-4161
Practice Address - Fax:515-241-4162
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IA19333207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAE69548Medicare UPIN