Provider Demographics
NPI:1013933803
Name:BURNEY, EDWARD N (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:N
Last Name:BURNEY
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5850 LANDERBROOK DR STE 306
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4071
Practice Address - Country:US
Practice Address - Phone:216-844-5144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-043850207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0515393Medicaid
OH363385OtherWELLCARE
OH000000221311OtherUNISON
OH000000512664OtherANTHEM
OHP00398012OtherRAILROAD MEDICARE
OH738038OtherBUCKEYE
OH000000127595OtherANTHEM
OH0660738OtherAETNA
OHP00398012OtherRAILROAD MEDICARE
OH0660738OtherAETNA
OH738038OtherBUCKEYE