Healthcare Provider Details

I. General information

NPI: 1255176871
Provider Name (Legal Business Name): ROBERT BURKET EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2024
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33200 WOODWARD AVE
BIRMINGHAM MI
48009-0902
US

IV. Provider business mailing address

8433 DALE
CENTER LINE MI
48015-1569
US

V. Phone/Fax

Practice location:
  • Phone: 248-942-8060
  • Fax:
Mailing address:
  • Phone: 248-840-9529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number519556
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: