Ellis, Burton
Ellis, Burton is an individual health care provider with primary practice located at 6825 Heirloom Cir , West Bloomfield MI 48322-4805. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Ellis, Burton can be contacted via phone (248) 497-1234.Contact Information
Primary practice address
6825 Heirloom Cir
West Bloomfield MI 48322-4805
Phone: (248) 497-1234
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 4301030106 | Michigan |
Profile Details
| NPI number | 1689633067 |
|---|---|
| LBN Legal business name | Ellis, Burton |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2006 |
| Last updated | Jul 17th, 2024 - 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 | 1689633067 | NPPES |
| Michigan | Other | 300F362420 | BCBSM |
| Michigan | MEDICAID | 2849514 | BCBSM |
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