Provider Demographics
NPI:1801896519
Name:BURKE, EDWARD F (DO)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:F
Last Name:BURKE
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:29900 LORRAINE AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-5266
Mailing Address - Country:US
Mailing Address - Phone:586-582-0864
Mailing Address - Fax:586-582-0964
Practice Address - Street 1:11012 E 13 MILE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2572
Practice Address - Country:US
Practice Address - Phone:586-582-0864
Practice Address - Fax:586-582-0964
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2013-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101006126207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1295126Medicaid
E25790Medicare UPIN
0E06376003Medicare ID - Type Unspecified