MEDICARE: DR. BRADLEY BURKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	4301091152	MI

General Provider Information

NPI Number	:	1215775614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY BURKE MD

Provider Business Mailing Address
First Line	:	3622 WOODLAND DR
Second Line	:
City	:	METAMORA
State	:	MI
Zip	:	48455-9626
Country	:	US
Telephone Number	:	810-797-2345
Fax Number	:

Provider Business Practice Location Address
First Line	:	3562 S LAPEER RD STE B
Second Line	:
City	:	METAMORA
State	:	MI
Zip	:	48455-8998
Country	:	US
Telephone Number	:	313-757-5172
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2024
Last Update Date	:	07/18/2024

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Directions to “ DR. BRADLEY BURKE MD” Practice Location

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