Provider Demographics
NPI:1811159791
Name:BURGER, BERDINE M (MD)
Entity type:Individual
Prefix:DR
First Name:BERDINE
Middle Name:M
Last Name:BURGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BERDINE
Other - Middle Name:M
Other - Last Name:BURGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2060 CHARLIE HALL BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6066
Mailing Address - Country:US
Mailing Address - Phone:843-571-7337
Mailing Address - Fax:843-723-3914
Practice Address - Street 1:2060 CHARLIE HALL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-6066
Practice Address - Country:US
Practice Address - Phone:843-571-7337
Practice Address - Fax:843-723-3914
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL30769207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC307698Medicaid
SCP01236559OtherRAILROAD MEDICARE
SC307698Medicaid
SC5909Medicare PIN
SC5912Medicare PIN
SC5910Medicare PIN