Individual
MICHELLE BURGESS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
235 GREENFIELD RD, SOUTH DEERFIELD, MA 01373-9790
(413) 665-2099
(413) 665-5189
Mailing address
235 GREENFIELD RD, SOUTH DEERFIELD, MA 01373-9790
(413) 665-2099
(413) 665-5189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
885
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
808005
CONNECTICARE
MA
Enumeration date
03/16/2006
Last updated
07/08/2007
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