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Individual

DR. TIMOTHY M BURANDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO, FACOS, FACS

Contact information

Practice address
5400 FORT ST, SUITE #150, TRENTON, MI 48183-4632
(734) 671-3678
(734) 671-3679
Mailing address
27118 WALLOON WAY, BROWNSTOWN, MI 48134-8071
(734) 795-7032
(734) 795-7032

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101008170
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2953577
MI
01
M97860002
MEDICARE ID TYPE UNSPECIFIED
MI
Enumeration date
08/01/2006
Last updated
06/10/2019
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