Individual
MICHAEL J BURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 W UNIVERSITY AVE, SUITE 403, MUNCIE, IN 47303-3409
(765) 289-6381
(765) 289-3883
Mailing address
2525 W UNIVERSITY AVE, SUITE 403, MUNCIE, IN 47303-3409
(765) 289-9415
(765) 289-3883
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01033256A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000711219
ANTHEM
IN
05
—
200112850
—
IN
01
—
P00968535
RR MEDICARE
IN
Enumeration date
05/09/2006
Last updated
04/04/2017
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