Burghardt, Tyson
Burghardt, Tyson is an individual health care provider with primary practice located at 804 Service Road Room A217, East Lansing MI 48824-7040. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Clinical Neurophysiology is his primary health care specialty. Burghardt, Tyson can be contacted via phone (517) 353-8122.Contact Information
Primary practice address
804 Service Road Room A217
East Lansing MI 48824-7040
Phone: (517) 353-8122
Fax: (517) 432-3713
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 4301092895 | Michigan |
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | 4301092895 | Michigan |
Profile Details
| NPI number | 1033353198 |
|---|---|
| LBN Legal business name | Burghardt, Tyson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2009 |
| Last updated | Jun 27th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033353198 | NPPES |
| Michigan | MEDICAID | 1033353198 |
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