Organization
DR. GARY BURNSTEIN COMMUNITY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN FULFORD BROX MD (CEO)
(248) 309-3795
Entity
Organization
Contact information
Practice address
45580 WOODWARD AVE, PONTIAC, MI 48341-5016
(248) 309-3795
(248) 309-3835
Mailing address
45580 WOODWARD AVE, PONTIAC, MI 48341-5016
(248) 309-3795
(248) 309-3835
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
333600000X
Pharmacy
—
—
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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