MEDICARE: FLORENCE BURKHARDT MIKLE 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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	4301048945	MI

General Provider Information

NPI Number	:	1376726810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FLORENCE BURKHARDT MIKLE M.D.

Provider Business Mailing Address
First Line	:	87 N MINGES RD
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-7909
Country	:	US
Telephone Number	:	269-966-4024
Fax Number	:

Provider Business Practice Location Address
First Line	:	87 N MINGES RD
Second Line	:
City	:	BATTLE CREEK
State	:	MI
Zip	:	49015-7909
Country	:	US
Telephone Number	:	269-966-4024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	12/06/2007

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