Provider Demographics
NPI:1578617148
Name:BURNESS, MONIKA LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:LEIGH
Last Name:BURNESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DRIVE
Practice Address - Street 2:B1 FLOOR CANCER CENTER RECP C
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5916
Practice Address - Country:US
Practice Address - Phone:734-936-6000
Practice Address - Fax:734-647-8789
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2012-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301101737207RX0202X, 207R00000X, 207RH0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology