Individual
CAROL G BURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6701 ROCKSIDE RD, SUITE 330, INDEPENDENCE, OH 44131-2358
(216) 524-4009
(216) 524-7933
Mailing address
6701 ROCKSIDE RD, SUITE 330, INDEPENDENCE, OH 44131-2358
(216) 524-4009
(216) 524-7933
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35045077
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000192649
ANTHEM
OH
05
—
0527746
—
OH
01
—
101091
KAISER
OH
01
—
P00131656
RAILROAD MEDICARE-SAG
OH
01
—
T45077
APEX-SUMMACARE
OH
Enumeration date
04/26/2006
Last updated
11/09/2007
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