Provider Demographics
NPI:1740253939
Name:BURKE, DENNIS WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:WILLIAM
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST YAW 3910
Practice Address - Street 2:ORTHOPAEDIC ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-3411
Practice Address - Fax:617-726-1612
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA45664207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6172172Medicaid
MAJ02554OtherBCBS MA
MA045664OtherTUFTS HEALTH PLAN
MA045664OtherTUFTS HEALTH PLAN
MAJ02554Medicare ID - Type Unspecified