Individual
MR. KEVIN TODD BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 WILLIAM CARLS DR, COMMERCE TOWNSHIP, MI 48382-2201
(248) 937-3300
Mailing address
1 WILLIAM CARLS DR, COMMERCE TOWNSHIP, MI 48382-2201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004844
MI
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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