Individual
PAUL BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
122 PINNELL ST, RIPLEY, WV 25271-9101
(304) 372-2731
(304) 373-1598
Mailing address
122 PINNELL ST, RIPLEY, WV 25271-9101
(304) 372-2731
(304) 373-1598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
16
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722-892
BLUE CROSS
—
05
—
0128362000
—
WV
01
—
550462730
TAX ID
WV
01
—
556000381
TAX ID
—
Enumeration date
08/25/2006
Last updated
05/04/2009
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