Provider Demographics
NPI:1215996194
Name:BURJA, IZABELA (MD)
Entity type:Individual
Prefix:
First Name:IZABELA
Middle Name:
Last Name:BURJA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1924 ALCOA HIGHWAY
Mailing Address - Street 2:THE UNIVERSITY OF TENNESSEE MEDICAL CENTER PATHOLOGY DE
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-6999
Mailing Address - Country:US
Mailing Address - Phone:865-305-8994
Mailing Address - Fax:865-305-6866
Practice Address - Street 1:1924 ALCOA HIGHWAY
Practice Address - Street 2:THE UNIVERSITY OF TENNESSEE MEDICAL CENTER PATHOLOGY DE
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-6999
Practice Address - Country:US
Practice Address - Phone:865-305-8994
Practice Address - Fax:865-305-6866
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2010-02-24
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Provider Licenses
StateLicense IDTaxonomies
TN25640207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3851820Medicaid
3851825Medicare ID - Type Unspecified
TN3851820Medicaid