# KREG BURNETTE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386701621
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | 12674 | NV | Yes |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | 35085188 | OH | — |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 10/29/2024

## 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 |