Provider Demographics
NPI:1417075987
Name:BUERKEL, DANIEL MARK (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MARK
Last Name:BUERKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W MITCHELL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2275
Mailing Address - Country:US
Mailing Address - Phone:231-487-2490
Mailing Address - Fax:231-487-6055
Practice Address - Street 1:560 W MITCHELL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2275
Practice Address - Country:US
Practice Address - Phone:231-487-2490
Practice Address - Fax:231-487-6055
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2017-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079973207RC0000X, 207RC0001X, 207R00000X
OH35095879207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3078940Medicaid
000000674243OtherANTHEM
06937OtherPARAMOUNT
OHP00864035OtherRAILROAD MEDICARE
OH3078940Medicaid
OH4298721Medicare PIN