1851536429 NPI number — BARBARA E HELLER BURSTEIN D O PLLC

Table of content: (NPI 1851536429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851536429 NPI number — BARBARA E HELLER BURSTEIN D O PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARBARA E HELLER BURSTEIN D O PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851536429
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 384
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CADILLAC
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49601-0384
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-775-6076
Provider Business Mailing Address Fax Number:
231-775-0027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4676 E BROOMFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48858-9192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-772-7600
Provider Business Practice Location Address Fax Number:
877-818-8934
Provider Enumeration Date:
12/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HELLER BURSTEIN
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
SINGLE MEMBERPHYSICIAN
Authorized Official Telephone Number:
989-772-7600

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  5101012114 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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