Provider Demographics
NPI:1720184229
Name:BURGOON, MACKAY & SCHULER, P.C.
Entity Type:Organization
Organization Name:BURGOON, MACKAY & SCHULER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACKAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:610-647-4161
Mailing Address - Street 1:266 LANCASTER AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3256
Mailing Address - Country:US
Mailing Address - Phone:610-647-4161
Mailing Address - Fax:610-647-5397
Practice Address - Street 1:266 LANCASTER AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3256
Practice Address - Country:US
Practice Address - Phone:610-647-4161
Practice Address - Fax:610-647-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA98940OtherBLUE CROSS BLUE SHIELD