Provider Demographics
NPI:1548559628
Name:BURKHART, BRIAN WESLEY (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WESLEY
Last Name:BURKHART
Suffix:
Gender:
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 GLENDALE DR SW
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-4678
Mailing Address - Country:US
Mailing Address - Phone:252-246-8960
Mailing Address - Fax:252-246-8961
Practice Address - Street 1:1704 GLENDALE DR SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4678
Practice Address - Country:US
Practice Address - Phone:252-246-8960
Practice Address - Fax:252-246-8961
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-006202083A0100X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program