Provider Demographics
NPI:1255348082
Name:BURKE, MILES J (MD)
Entity type:Individual
Prefix:DR
First Name:MILES
Middle Name:J
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10475 MONTGOMERY RD
Mailing Address - Street 2:SUITE 4F
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5201
Mailing Address - Country:US
Mailing Address - Phone:513-984-4949
Mailing Address - Fax:513-794-7552
Practice Address - Street 1:10475 MONTGOMERY RD
Practice Address - Street 2:SUITE 4F
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5201
Practice Address - Country:US
Practice Address - Phone:513-984-4949
Practice Address - Fax:513-794-7552
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH43594207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08 20061OtherUNITED HEALTHCARE
OH3336004 001OtherCIGNA
OHOC00959OtherNATIONWIDE
OHCM319OtherHEALTH REACH
OH0949899OtherAETNA
OH31157761201OtherPACIFICARE
OH86516OtherHEALTH PARTNERS
OH3336004 001OtherCIGNA
OHC01760Medicare UPIN