Individual
BRIAN BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2433 BYRON CENTER AVE SW, 203, WYOMING, MI 49519-2196
(616) 819-9808
Mailing address
2433 BYRON CENTER AVE SW, 203, WYOMING, MI 49519-2196
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
07MC14
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10114
CMS
MI
Enumeration date
04/12/2008
Last updated
04/12/2008
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