Individual
KEVIN BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8865 W 400 N STE 155, MICHIGAN CITY, IN 46360-9010
(219) 872-6566
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
02005423A
IN
207RG0100X
Gastroenterology Physician
Primary
02005423A
IN
208M00000X
Hospitalist Physician
02005423A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017636
—
IN
Enumeration date
04/30/2015
Last updated
04/14/2023
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