Healthcare Provider Details

I. General information

NPI: 1962402883
Provider Name (Legal Business Name): STEVEN S. BURMEISTER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 07/20/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2984 HENRY ST
NORTON SHORES MI
49441-4014
US

IV. Provider business mailing address

2984 HENRY ST
NORTON SHORES MI
49441-4014
US

V. Phone/Fax

Practice location:
  • Phone: 231-737-7700
  • Fax: 231-737-7700
Mailing address:
  • Phone: 231-737-7700
  • Fax: 231-737-7700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901003194
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: