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NPI Code Detail

MEDICARE: DENISE MICHELLE BURROUGHS PA-C

MEDICARE:   DENISE MICHELLE BURROUGHS  PA-C
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
1363AM0700XMedical Physician Assistant5601003528MI

General Provider Information

NPI Number : 1093979270
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE MICHELLE BURROUGHS PA-C
Provider Business Mailing Address
First Line : 3121 RAYBORN DR
Second Line :
City : LANSING
State : MI
Zip : 48911-1444
Country : US
Telephone Number : 517-882-2832
Fax Number :
Provider Business Practice Location Address
First Line : 5135 S PENN AVE
Second Line :
City : LANSING
State : MI
Zip : 48911-4002
Country : US
Telephone Number : 517-887-5922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2008
Last Update Date : 07/16/2008

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Directions to “ DENISE MICHELLE BURROUGHS PA-C” Practice Location

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