Individual
LOLA J BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
428 MORGANTOWN ST STE 1, KINGWOOD, WV 26537-1140
(304) 329-7124
(304) 329-7092
Mailing address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-1400
(304) 329-1175
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25293
WV
207Q00000X
Family Medicine Physician
39113
SC
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
25293
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810027539
—
SC
Enumeration date
05/31/2011
Last updated
03/19/2025
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