Individual
DEMETRIUS BURKE-HAGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
717 N CENTER DR NW, GRAND RAPIDS, MI 49544-8215
(616) 301-8000
Mailing address
717 N CENTER DR NW, GRAND RAPIDS, MI 49544-8215
(616) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912510033
—
MI
Enumeration date
08/28/2020
Last updated
03/30/2026
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