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NPI Code Detail

MEDICARE: MARY BURTON M.D.

MEDICARE: MARY BURTON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4301054386MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2430105486OTHERMISTATE LISCENSE

General Provider Information

NPI Number : 1033108337
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY BURTON M.D.
Provider Business Mailing Address
First Line : 3500 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5353
Country : US
Telephone Number : 586-977-6356
Fax Number :
Provider Business Practice Location Address
First Line : 3500 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5353
Country : US
Telephone Number : 586-977-6356
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2005
Last Update Date : 03/07/2023

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