MEDICARE: PAUL XAVIER BURGOYNE MD

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	207Q00000X	Family Medicine Physician	4301065935	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0P27380	OTHER	MI	MEDICARE GROUP LEGACY #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	700E031610	OTHER	MI	BCBS GROUP NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407823339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL XAVIER BURGOYNE MD

Provider Business Mailing Address
First Line	:	19901 E 10 MILE RD
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-1069
Country	:	US
Telephone Number	:	586-777-1277
Fax Number	:	586-777-0106

Provider Business Practice Location Address
First Line	:	19901 E 10 MILE RD
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-1069
Country	:	US
Telephone Number	:	586-777-1277
Fax Number	:	586-777-0106

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	09/28/2011

Similar Medicare Providers

1407822612 — DR. LAURIE JEAN RUDNICK M.D.
Practice Location Address:

19901 E 10 MILE RD
SAINT CLAIR SHORES, MI
48080-1069

Practice Phone: 586-777-1277
Practice Fax: 586-777-0106

1891761821 — ANTHONY PANICCIA MD
Practice Location Address:

19901 E 10 MILE RD
ST CLAIR SHORES, MI
48080-1069

Practice Phone: 586-777-1277
Practice Fax: 586-777-0106

1659319218 — DR. BARRY ALLEM MENTZEL D.D.S.
Practice Location Address:

19925 E 10 MILE RD
ST CLAIR SHORES, MI
48080-1069

Practice Phone: 586-772-1880
Practice Fax:

1386716520 — ST. JOHN HOSPITAL AND MEDICAL CENTER
Practice Location Address:

19901 E 10 MILE RD
SAINT CLAIR SHORES, MI
48080-1069

Practice Phone: 586-777-1277
Practice Fax: 586-777-0106

1700053634 — BARRY A. MENTZEL, D.D.S., P.C.
Practice Location Address:

19925 E 10 MILE RD
SAINT CLAIR SHORES, MI
48080-1069

Practice Phone: 586-772-1880
Practice Fax: 586-772-5837

1679881510 — ST. JOHN HOSPITAL AND MEDICAL CENTER
Practice Location Address:

19901 E 10 MILE RD
SAINT CLAIR SHORES, MI
48080-1069

Practice Phone: 586-777-1277
Practice Fax: 586-777-0106

Directions to “ PAUL XAVIER BURGOYNE MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.