Individual
JACOB MICHAEL BURKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-1020
Mailing address
1395 ANTIETAM AVE APT 59, DETROIT, MI 48207-2875
(586) 246-1645
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301503928
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2018
Last updated
09/21/2021
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