1629172143 NPI number — DR. RACHEL G BURGAN MD

Table of content: DR. RACHEL G BURGAN MD (NPI 1629172143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629172143 NPI number — DR. RACHEL G BURGAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURGAN
Provider First Name:
RACHEL
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629172143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 POT SPRING RD
Provider Second Line Business Mailing Address:
HEALTH OFFICE
Provider Business Mailing Address City Name:
TIMONIUM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-2732
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-252-4000
Provider Business Mailing Address Fax Number:
410-252-0869

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 POT SPRING RD
Provider Second Line Business Practice Location Address:
HEALTH OFFICE
Provider Business Practice Location Address City Name:
TIMONIUM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21093-2732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-252-4000
Provider Business Practice Location Address Fax Number:
410-252-0869
Provider Enumeration Date:
09/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  D0058921 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 876376 . This is a "OPT CHOICE SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21378495 . This is a "CIGNA RACHEL BURGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4334238 . This is a "AETNA RONA STEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8127075 . This is a "OPT CHOICE RACHEL BURGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 52896007 . This is a "BCBS MD SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21378495 . This is a "CIGNA SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6936 . This is a "AMERIGROUP RONA STEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2127075 . This is a "MAMSI RACHEL BURGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7561382 . This is a "AETNA RACHEL BURGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: E6370004 . This is a "BLUE CHOICE RONA STEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 235997 . This is a "AMERIGROUP RACHEL BURGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4348015 . This is a "AETNA SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: E6370006 . This is a "BLUE CHOICE RACHEL BURGAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 40303109 . This is a "BCBS MD RONA STEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: E6370002 . This is a "BLUE CHOICE SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21378495 . This is a "CIGNA RONA STEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 274379 . This is a "MAMSI RONA STEIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 275376 . This is a "MAMSI SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8128 . This is a "AMERIGROUP SHARI COHEN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 874379 . This is a "OPT CHOICE RONA STEIN" identifier . This identifiers is of the category "OTHER".




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