Jacob M. Burke
Emergency Medicine Physician in Detroit, MI(View on Map)
Full Name
Jacob Michael Burke
NPI Number
1013413673
NPI Type
Individual Provider
Gender
Male
Enumeration Date
04/03/2018
Specialties
(Taxonomies)Code
207P00000X
390200000X
Primary Taxonomy
Yes
No
Licenses
State
Michigan
License Number
4301503928
Contact
Information
Purpose
Mailing
Location
Address
1395 ANTIETAM AVE APT 59
6071 W OUTER DR
City
Detroit
Detroit
State
MI
MI
Postal Code
48207-2875
48235-2624
Country
US
US
Telephone Number
(586) 246-1645
(313) 966-1020
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/21/2021
Provider Address
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