Individual
DR. TYSON BURGHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
804 SERVICE ROAD, ROOM A217, EAST LANSING, MI 48824-7040
(517) 353-8122
(517) 432-3713
Mailing address
804 SERVICE RD STE A109B, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
4301092895
MI
2084N0600X
Clinical Neurophysiology Physician
Primary
4301092895
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033353198
—
MI
Enumeration date
04/20/2009
Last updated
06/27/2023
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