Provider Demographics
NPI:1942658117
Name:BURGER, MARC ANDREW
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:ANDREW
Last Name:BURGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 TIOHERO BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-3382
Mailing Address - Country:US
Mailing Address - Phone:248-568-4030
Mailing Address - Fax:
Practice Address - Street 1:4980 TIOHERO BLVD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-3382
Practice Address - Country:US
Practice Address - Phone:248-568-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-29
Last Update Date:2016-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other