# DR. GARY BURNSTEIN COMMUNITY HEALTH CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073188736
- **Authorized official:** DR. JUSTIN FULFORD BROX MD (CEO)
- **Authorized official phone:** (248) 309-3795

## Contact information

- **Practice address:** 45580 WOODWARD AVE, PONTIAC, MI 48341-5016
- **Practice address phone:** (248) 309-3795
- **Practice address fax:** (248) 309-3835
- **Mailing address:** 45580 WOODWARD AVE, PONTIAC, MI 48341-5016
- **Mailing address phone:** (248) 309-3795
- **Mailing address fax:** (248) 309-3835

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251V00000X | Voluntary or Charitable Agency | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QD0000X | Dental Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 05/25/2021
- **Last updated:** 05/25/2021