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Individual

KELLY A BURDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
104 ENDICOTT ST, SUITE 104, DANVERS, MA 01923-3623
(978) 882-6700
(978) 646-8553
Mailing address
104 ENDICOTT ST, SUITE 104, DANVERS, MA 01923-3623
(978) 882-6700
(978) 646-8553

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
238168
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0594705
IA
05
12903
ND
01
2364662
ARAZ/ AMERICA'S PPO
SD
01
247072
MIDLANDS CHOICE
SD
01
3100277
MEDICA
SD
01
341G8BU
BLUE CROSS
MN
01
370624200
DEPT OF LABOR
SD
01
406751043656
PREFERRED ONE
SD
01
45364
SANFORD HEALTH PLAN
SD
05
46022474344
NE
01
4994483
BLUE CROSS
SD
01
5561
DAKOTACARE
SD
01
57105P008
WPS TRICARE
SD
05
6631200
SD
05
934628700
MN
01
HP52482
HEALTHPARTNERS
SD
01
P00368122
RR MEDICARE
SD
Enumeration date
02/23/2006
Last updated
02/29/2012
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