Provider Demographics
NPI:1801973144
Name:BURAK, MICHAEL MAURICE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MAURICE
Last Name:BURAK
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 1:2579 HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6113
Mailing Address - Country:US
Mailing Address - Phone:215-938-6040
Mailing Address - Fax:215-938-6042
Practice Address - Street 1:2579 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6113
Practice Address - Country:US
Practice Address - Phone:215-938-6040
Practice Address - Fax:215-938-6042
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006453-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0877364000OtherBLUE CROSS
PA0877364000OtherBLUE CROSS