Healthcare Provider Details

I. General information

NPI: 1932315397
Provider Name (Legal Business Name): BURCH HILDEBRANDT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 W HURON ST SUITE 6
ANN ARBOR MI
48103-4200
US

IV. Provider business mailing address

29994 NORTHWESTERN HWY SUITE I
FARMINGTON HILLS MI
48334-3225
US

V. Phone/Fax

Practice location:
  • Phone: 734-741-8066
  • Fax:
Mailing address:
  • Phone: 248-855-5554
  • Fax: 248-851-8698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES ANDREW BURCH
Title or Position: SECRETARY TREASURER
Credential: PH.D.
Phone: 248-855-5554