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Individual
KREG BURNETTE
Active
Individual
KREG BURNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
12674
NV
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
35085188
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221191
UNISON
OH
01
—
000000527951
ANTHEM
OH
01
—
1021120630001
PA MEDICAID
PA
05
—
2544063
—
OH
01
—
414954
WELLCARE
OH
01
—
7167702
AETNA
OH
01
—
731269
BUCKEYE
OH
Enumeration date
01/03/2007
Last updated
10/29/2024
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