Provider Demographics
NPI:1902848021
Name:BURKA, BARRETT LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:LEWIS
Last Name:BURKA
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 1:6507 SUNNY HILL CT
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-1640
Mailing Address - Country:US
Mailing Address - Phone:703-930-8766
Mailing Address - Fax:703-893-0393
Practice Address - Street 1:6507 SUNNY HILL CT
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-1640
Practice Address - Country:US
Practice Address - Phone:703-930-8766
Practice Address - Fax:703-893-0393
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD17191207R00000X
VA29939207R00000X
DCMD 9170207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD968021700Medicaid
DC021924500Medicaid