Individual
DR. EDWARD JEROME BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2450 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2179
(702) 877-8661
(702) 667-4689
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(022) 427-1979
(702) 667-4689
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H9829
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050074423
RAILROAD MEDICARE
TX
05
—
119275902
—
TX
05
—
119275904
—
TX
01
—
80772Y
TX-BLUE SHIELD
—
01
—
P00962837
RR MEDICARE
TX
Enumeration date
01/04/2007
Last updated
01/22/2020
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