Provider Demographics
NPI:1306584891
Name:BURDO, TATUM ELYSE (MD, MPH)
Entity type:Individual
Prefix:MRS
First Name:TATUM
Middle Name:ELYSE
Last Name:BURDO
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BARTON STREET
Mailing Address - Street 2:JERICHO ROAD/BUFFALO GENERAL MEDICAL CENTER
Mailing Address - City:BU
Mailing Address - State:NY
Mailing Address - Zip Code:14213
Mailing Address - Country:US
Mailing Address - Phone:716-881-6191
Mailing Address - Fax:
Practice Address - Street 1:184 BARTON STREET
Practice Address - Street 2:JERICHO ROAD/BUFFALO GENERAL MEDICAL CENTER
Practice Address - City:BU
Practice Address - State:NY
Practice Address - Zip Code:14213
Practice Address - Country:US
Practice Address - Phone:716-881-6191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program