Provider Demographics
NPI:1811328396
Name:NUNEZ BURGOS, MIGUEL TOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:MIGUEL
Middle Name:TOMAS
Last Name:NUNEZ BURGOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13206 BOTHELL EVERETT HWY STE 401A
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-3402
Mailing Address - Country:US
Mailing Address - Phone:833-411-5469
Mailing Address - Fax:
Practice Address - Street 1:13206 BOTHELL EVERETT HWY STE 401A
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-3402
Practice Address - Country:US
Practice Address - Phone:833-411-5469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-09
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09454600207R00000X
WAMD61261486207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine