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General NPI Number Information
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NPI Number | 1972710945
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Entity Type | Organization
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Legal Business Name | MICHAEL P. BURK, D.P.M., PLLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 03/31/2009
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Provider Practice Location Address
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Address Line | 39555 W 10 MILE RD SUITE 307
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City | NOVI
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State | MI
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Zip | 48375-2950
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Country | US
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Telephone | 248-476-1500
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Fax | 248-476-0502
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Provider Business Mailing Address
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Address Line | 39555 W 10 MILE RD SUITE 307
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City | NOVI
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State | MI
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Zip | 48375-2950
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Country | US
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Telephone | 248-476-1500
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Fax | 248-476-0502
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL PATRICK BURK
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Credential | D.P.M.
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Telephone | 248-476-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 5901001081
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License Number State | MI
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