Basic Information
| Provider Information | |||||||||
| NPI: | 1255573374 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BURKE | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | CASEY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 79777 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212790777 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4346547794 | ||||||||
| FaxNumber: | 4346547582 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 MARTHA JEFFERSON DR | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 229114668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4346547580 | ||||||||
| FaxNumber: | 4346547582 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2009 | ||||||||
| LastUpdateDate: | 11/13/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MA09390100 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 2012-00025 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0002X | 0101266483 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 208M00000X | 0101266483 | VA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.