Provider Demographics
NPI:1396038832
Name:BURCH, STEVEN JAMES (DO)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:BURCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19800 EAST ST STE 120
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:IN
Practice Address - Zip Code:46074-3833
Practice Address - Country:US
Practice Address - Phone:463-622-9200
Practice Address - Fax:463-622-9201
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02003896A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201137170Medicaid
INP01291694OtherMEDICARE RR PTAN
IN266180304Medicare PIN