Individual
LISA L BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5700 MONROE ST UNIT 203, SYLVANIA, OH 43560-2735
(419) 843-8100
(419) 841-4681
Mailing address
5700 MONROE ST UNIT 203, SYLVANIA, OH 43560-2735
(419) 843-8100
(419) 841-4681
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.007455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213037
ANTHEM
OH
01
—
04283
PARAMOUNT
OH
01
—
080184742
RAILROAD MEDICARE
OH
05
—
114696998
—
MI
05
—
2320652
—
OH
01
—
725860
BUCKEYE
OH
01
—
7837353
AETNA
OH
01
—
LB016293
MI BC
MI
01
—
P00198234
RAILROAD MEDICARE
OH
Enumeration date
12/21/2005
Last updated
11/03/2023
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