Provider Demographics
NPI:1669485496
Name:MAYS, BURKE RAFER (DC)
Entity Type:Individual
Prefix:DR
First Name:BURKE
Middle Name:RAFER
Last Name:MAYS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4254 ISLEMOUNT PL
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-1577
Mailing Address - Country:US
Mailing Address - Phone:612-242-0045
Mailing Address - Fax:952-925-2404
Practice Address - Street 1:5851 DULUTH ST
Practice Address - Street 2:SUITE 115
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-3946
Practice Address - Country:US
Practice Address - Phone:763-634-5892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN003502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN476M5MAOtherBLUE CROSS BLUE SHIELD
MN476M5MAOtherBLUE CROSS BLUE SHIELD
MNU66545Medicare UPIN