| Christopher Sullivan Bourke Jr, DPM | |
|
6501 Loisdale Ct, Springfield, VA 22150-1826 | |
| (703) 922-1000 | |
| Not Available |
| Full Name | Christopher Sullivan Bourke Jr |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 11 Years |
| Location | 6501 Loisdale Ct, Springfield, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225456361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | SC006559 (Pennsylvania) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | E5421 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc | 3779495858 | 1793 |
| Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc | 3779495858 | 1793 |
| Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc | 3779495858 | 1793 |
| Provider Name | Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1043378656 PECOS PAC ID: 3779495858 Enrollment ID: O20080519000558 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Sullivan Bourke Jr, DPM 6501 Loisdale Ct, Springfield, VA 22150-1826 Ph: () - | Christopher Sullivan Bourke Jr, DPM 6501 Loisdale Ct, Springfield, VA 22150-1826 Ph: (703) 922-1000 |
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