Provider Demographics
NPI:1053554782
Name:BURKE, VICTORIA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ELIZABETH
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1408 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-1037
Mailing Address - Country:US
Mailing Address - Phone:504-481-1368
Mailing Address - Fax:
Practice Address - Street 1:1542 TULANE AVE
Practice Address - Street 2:RM. 331
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2865
Practice Address - Country:US
Practice Address - Phone:504-568-5031
Practice Address - Fax:504-568-5553
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206887207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2371410Medicaid
MS07088338OtherMEDICAID
LA2371410Medicaid