Provider Demographics
NPI:1013988856
Name:BURKET, RAMON C (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:C
Last Name:BURKET
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 1:100 NASON DRIVE
Mailing Address - Street 2:COVE MEDICAL CENTER SUITE #103
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-1201
Mailing Address - Country:US
Mailing Address - Phone:814-224-2213
Mailing Address - Fax:814-224-5879
Practice Address - Street 1:100 NASON DRIVE
Practice Address - Street 2:COVE MEDICAL CENTER SUITE #103
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-1201
Practice Address - Country:US
Practice Address - Phone:814-224-2213
Practice Address - Fax:814-224-5879
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-006481-E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005951280002Medicaid
PA39037OtherGEISINGER HEALTH PLAN
PA154OtherHEALTH ASSURANCE
PA14296OtherUPMC
PA015041Medicare ID - Type Unspecified
PA154OtherHEALTH ASSURANCE