MEDICARE: MICHAEL D BURDAY 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	207R00000X	Internal Medicine Physician	ME121870	FL
2	207R00000X	Internal Medicine Physician	44364	MA

General Provider Information

NPI Number	:	1558325266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D BURDAY MD

Provider Business Mailing Address
First Line	:	10051 5TH STREET NORTH #200
Second Line	:	ATTN. CREDENTIALING
City	:	ST. PETERSBURG
State	:	FL
Zip	:	01605
Country	:	US
Telephone Number	:	941-847-7903
Fax Number	:	941-847-7919

Provider Business Practice Location Address
First Line	:	931 10TH ST E
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-4131
Country	:	US
Telephone Number	:	941-847-7903
Fax Number	:	941-847-7919

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	12/13/2016

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