Individual
MR. THOMAS J BURGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
93 BROAD ST, ASHLAND, PA 17921-2101
(570) 875-0512
(570) 875-0534
Mailing address
3891 RANCHERO DR, SUITE 10, ANN ARBOR, MI 48108-2773
(734) 822-1570
(734) 213-1594
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036183
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AS1839572
HIGHMARK BCBS
PA
Enumeration date
06/18/2006
Last updated
07/08/2007
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