Individual
SAMIA BURTON
Active
Individual
SAMIA BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01047936
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000081502
ANTHEM
IN
01
—
000000547923
ANTHEM PIN #
IN
05
—
200199960
—
IN
01
—
200311740F
MEDICAID GROUP #
IN
01
—
7021010
AETNA PIN #
IN
01
—
Q0417069
SHO
IN
Enumeration date
12/29/2005
Last updated
12/20/2013
Update your record
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