Basic Information
| Provider Information | |||||||||
| NPI: | 1003929613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURKHARDT | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 ST. PAUL PLACE | ||||||||
| Address2: | MEDICAL STAFF OFFICE | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106592802 | ||||||||
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| Practice Location | |||||||||
| Address1: | 227 ST. PAUL PLACE | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103329200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 10/06/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | C0001328 | MD | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | C0001328 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.