Provider Demographics
NPI:1013696681
Name:BURKE, DEVON ANTONIS
Entity Type:Individual
Prefix:MR
First Name:DEVON
Middle Name:ANTONIS
Last Name:BURKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18337 HALLMARK CT
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-4669
Mailing Address - Country:US
Mailing Address - Phone:240-342-9339
Mailing Address - Fax:
Practice Address - Street 1:18337 HALLMARK CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-4669
Practice Address - Country:US
Practice Address - Phone:240-342-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator