Individual
SCOTT DAVID BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 LEFFINGWELL AVE NE, SUITE 200, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
(616) 464-6170
Mailing address
1111 LEFFINGWELL AVE NE, SUITE 200, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
(616) 464-6170
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4301087092
MI
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
4301087092
MI
208600000X
Surgery Physician
4301087092
MI
2086S0105X
Surgery of the Hand (Surgery) Physician
4301087092
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4834931
—
MI
Enumeration date
02/06/2006
Last updated
07/01/2016
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