Individual
MICHAEL R BURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 N TILLOTSON AVE, SUITE, MUNCIE, IN 47304-3900
(765) 289-2353
Mailing address
205 N TILLOTSON AVE, SUITE, MUNCIE, IN 47304-3900
(765) 289-2353
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01028368
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200014320A
—
IN
Enumeration date
02/15/2006
Last updated
04/02/2013
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