Healthcare Provider Details

I. General information

NPI: 1184226870
Provider Name (Legal Business Name): PATRICK BURMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 OLD LANSING RD
LANSING MI
48917-4392
US

IV. Provider business mailing address

1165 N CHIPMAN ST
OWOSSO MI
48867-4955
US

V. Phone/Fax

Practice location:
  • Phone: 517-657-2980
  • Fax: 517-993-5982
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: