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General NPI Number Information
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NPI Number | 1376830190
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Entity Type | Individual
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Provider Name | MEGAN LUCILLE BURROUGHS D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 825 N CENTER AVE
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City | GAYLORD
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State | MI
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Zip | 49735-1592
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Country | US
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Telephone | 231-947-0673
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Fax | 801-740-2847
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Provider Business Mailing Address
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Address Line | 1000 HARRINGTON ST
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2920
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Country | US
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Telephone | 586-493-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 5101019496
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101019496
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 5101019496
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License Number State | MI
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