Provider Demographics
NPI:1699391219
Name:BURCHELL, MARGARET DILLON (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:DILLON
Last Name:BURCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-5512
Mailing Address - Country:US
Mailing Address - Phone:650-685-6784
Mailing Address - Fax:
Practice Address - Street 1:1524 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-5512
Practice Address - Country:US
Practice Address - Phone:650-685-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG83511208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics