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Organization

CRAIG G. BURKHART, M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CRAIG G BURKHART M.D. (DERMATOLOGIST)
(419) 885-3403
Entity
Organization

Contact information

Practice address
5600 MONROE ST, BLDG B, SUITE 106, SYLVANIA, OH 43560-2731
(419) 885-3403
(419) 885-3401
Mailing address
5600 MONROE ST, BLDG B, SUITE 106, SYLVANIA, OH 43560-2731
(419) 885-3403
(419) 885-3401

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35042675
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000027630
ANTHEM BCBS
OH
01
00058
PARAMOUNT HEALTHCARE
OH
01
1560520
MI MEDICAID
MI
05
2809269
OH
01
298402332001
MEDICAL MUTUAL
OH
Enumeration date
07/26/2006
Last updated
05/09/2008
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