Provider Demographics
NPI:1093538712
Name:BURWINKEL, MARY MARGARET (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:BURWINKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7480 ZION HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002-9694
Mailing Address - Country:US
Mailing Address - Phone:513-574-5625
Mailing Address - Fax:
Practice Address - Street 1:7480 ZION HILL ROAD
Practice Address - Street 2:
Practice Address - City:CLEVES
Practice Address - State:OH
Practice Address - Zip Code:45002-9694
Practice Address - Country:US
Practice Address - Phone:513-574-5625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-047867208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice