Individual
DR. GLEN E BURMEISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
(303) 761-9190
Mailing address
10700 E GEDDES AVE, NO 200, ENGLEWOOD, CO 80112-3800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
17672
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01176726
—
CO
01
—
02312247
NY MEDICAID
NY
05
—
10025709000
—
NE
01
—
104686051
MI MEDICAID
MI
05
—
1366428500
—
MT
05
—
1366428500
—
WY
05
—
1679513196
—
UT
01
—
200418410A
KS MEDICAID
KS
01
—
300048674
RR MCRE MIC
CO
01
—
300090005
RR MCRE RIA
CO
01
—
300090006
RR MCRE DIA
CO
01
—
53212901
TX MEDICAID
TX
05
—
84-0597929
—
NE
01
—
8492233
WA MEDICAID
WA
05
—
85429562
—
NM
01
—
922288
AZ MEDICAID
AZ
01
—
CO305780
MEDICARE TRAILBLAZER
NE
01
—
NA1214056
WPS NA 1214 RIN MCR PIN
NE
01
—
NA1215056
WPS NA 1215 RIN MCR PIN
NE
01
—
XPY201235
CA MEDICAID
CA
Enumeration date
12/20/2005
Last updated
05/25/2011
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