Basic Information
Provider Information
NPI: 1669883492
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURKE
FirstName: KALEIGH
MiddleName: LINDEMAN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3949 BROWNING PL
Address2:  
City: RALEIGH
State: NC
PostalCode: 276096536
CountryCode: US
TelephoneNumber: 9197877411
FaxNumber:  
Practice Location
Address1: 3949 BROWNING PL
Address2:  
City: RALEIGH
State: NC
PostalCode: 276096536
CountryCode: US
TelephoneNumber: 9197877411
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/14/2014
LastUpdateDate: 01/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X201160NCN Student, Health CareStudent in an Organized Health Care Education/Training Program 
2085B0100X2018-00497NCY Allopathic & Osteopathic PhysiciansRadiologyBody Imaging

No ID Information.


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