Provider Demographics
NPI:1215178249
Name:BURGIN, DEBORAH JEAN (RT)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JEAN
Last Name:BURGIN
Suffix:
Gender:F
Credentials:RT
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:JEAN
Other - Last Name:FAVIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RT
Mailing Address - Street 1:10972 MAPLEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8857
Mailing Address - Country:US
Mailing Address - Phone:734-945-1706
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-763-2573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography