Provider Demographics
NPI:1881679363
Name:BURGER, DAVID GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GERARD
Last Name:BURGER
Suffix:
Gender:M
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:PO BOX 25608
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84125-0608
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:7320 216TH ST SW
Practice Address - Street 2:SUITE 210
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-8006
Practice Address - Country:US
Practice Address - Phone:425-744-1777
Practice Address - Fax:425-744-1790
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60317112207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103713703Medicaid
TXP00234443OtherMEDICARE RAILROAD
TX103713704Medicaid
TX8J1290Medicare PIN
TX103713704Medicaid
TX103713703Medicaid
TX8D6700Medicare PIN