Individual
MARY BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301054386
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430105486
STATE LISCENSE
MI
05
—
4737188
—
MI
Enumeration date
10/19/2005
Last updated
03/07/2023
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