Provider Demographics
NPI:1104880038
Name:BURK, LINDA A (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:A
Last Name:BURK
Suffix:
Gender:F
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 1267
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-1267
Mailing Address - Country:US
Mailing Address - Phone:336-719-7112
Mailing Address - Fax:336-786-3752
Practice Address - Street 1:100 N POINTE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-2266
Practice Address - Country:US
Practice Address - Phone:336-789-6267
Practice Address - Fax:336-786-4245
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-00190208000000X
VA0101223072208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006700217Medicaid
VA006700217Medicaid