Individual
CHRISTOPHER A BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., MPH
Contact information
Practice address
750 STEWART RD, SUITE #2, MONROE, MI 48162-4291
(734) 242-8630
(734) 242-8666
Mailing address
44038 PARKSIDE ST, CANTON, MI 48187-2117
(734) 459-4805
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002739
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB002739
COMERCIAL BCBS MI VISION
MI
Enumeration date
11/17/2006
Last updated
07/08/2007
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