Individual
DR. MICAH MATTHEW BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3410 WORTH ST, DALLAS, TX 75246-2003
(214) 370-1000
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M9889
TX
207RX0202X
Medical Oncology Physician
Primary
M3964
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199083002
—
TX
01
—
8DE930
BCBS
TX
01
—
P01208492
RAILROAD MEDICARE
TX
Enumeration date
05/28/2008
Last updated
08/14/2014
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