Provider Demographics
NPI:1487839353
Name:TORRES-BURGOS, DIANA EVELYN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:EVELYN
Last Name:TORRES-BURGOS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:EVELYN
Other - Last Name:TORRES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:555 TOWNER ST
Mailing Address - Street 2:PO BOX 915
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5752
Mailing Address - Country:US
Mailing Address - Phone:734-544-6700
Mailing Address - Fax:734-544-6704
Practice Address - Street 1:555 TOWNER ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5752
Practice Address - Country:US
Practice Address - Phone:734-544-6700
Practice Address - Fax:734-544-6704
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010829922083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine