Provider Demographics
NPI:1730484692
Name:BUREK, GREGORY ADAM (PA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ADAM
Last Name:BUREK
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2700 S ROCHESTER RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4547
Mailing Address - Country:US
Mailing Address - Phone:947-252-2002
Mailing Address - Fax:248-575-4144
Practice Address - Street 1:2700 S ROCHESTER RD STE A
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4547
Practice Address - Country:US
Practice Address - Phone:248-212-0777
Practice Address - Fax:248-575-4144
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005946363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant