Provider Demographics
NPI:1285936187
Name:BURKHARD, EDWARD JOHN JR (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:JOHN
Last Name:BURKHARD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 BROOKHAVEN DR W
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-9696
Mailing Address - Country:US
Mailing Address - Phone:610-437-9384
Mailing Address - Fax:
Practice Address - Street 1:1888 BROOKHAVEN DR W
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-9696
Practice Address - Country:US
Practice Address - Phone:610-437-9384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-27
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD005676E207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology