MEDICARE: DR. MICHELE DOREEN BURGET 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	2080A0000X	Pediatric Adolescent Medicine Physician	0101232551	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	289596	OTHER	VA	ANTHEM PROVIDER #
2	541381483	OTHER	VA	TAX ID #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	10012164	OTHER	VA	OPTIMA PROVIDER #
5	7778179	OTHER	VA	CIGNA PROVIDER #
6	010030498	OTHER	VA	VIRGINIA PREMIER PROV #
7	8114312	OTHER	VA	MAMSI ALLIANCE PROVIDER #
8	0000241787301	OTHER	VA	UNITED HEALTHCARE PROV#
9	7447576	OTHER	VA	AETNA PROVIDER #
10	778179	OTHER	VA	SOUTHERN HEALTH PROV#

General Provider Information

NPI Number	:	1730224304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE DOREEN BURGET M.D.

Provider Business Mailing Address
First Line	:	1583 STANDING RIDGE DR STE E
Second Line	:
City	:	POWHATAN
State	:	VA
Zip	:	23139-8051
Country	:	US
Telephone Number	:	804-375-1589
Fax Number	:	804-325-1190

Provider Business Practice Location Address
First Line	:	1583 STANDING RIDGE DR STE E
Second Line	:
City	:	POWHATAN
State	:	VA
Zip	:	23139-8051
Country	:	US
Telephone Number	:	804-375-1589
Fax Number	:	804-325-1190

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	05/20/2026

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