Provider Demographics
NPI:1871974741
Name:BURGIN, SIERRA NICOLE (MD)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:NICOLE
Last Name:BURGIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:NICOLE
Other - Last Name:CUTCHIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 S NEW BALLAS RD
Mailing Address - Street 2:OB/GYN
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8221
Mailing Address - Country:US
Mailing Address - Phone:314-251-6062
Mailing Address - Fax:314-251-4376
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:OB/GYN
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6062
Practice Address - Fax:314-251-4376
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015018576207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology