Burgess, Ernie

Burgess, Ernie is an individual health care provider with primary practice located at 116 E 8Th St , Traverse City MI 49684-2524. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Driver, Other Service Providers / Peer Specialist. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Burgess, Ernie can be contacted via phone (231) 922-4810.

Contact Information

Primary practice address
116 E 8Th St Traverse City MI 49684-2524
Phone: (231) 922-4810
Fax: (231) 943-2590
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Driver 172A00000X
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1194179622
LBN Legal business name Burgess, Ernie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2016
Last updated Apr 21st, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194179622 NPPES
Michigan MEDICAID 1184087272
Michigan MEDICAID 1629431713

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