MALISA M BURT (NPI# 1578973657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578973657 |
| Entity Type | Individual |
| Full Name | MALISA M BURT |
| Credential | PA |
| Practice Address |
127 Forest Ave Royal Oak MI 48067-1843 |
| Practice Telephone | 2482297927 |
| Mailing Telephone | 2482297927 |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2014-04-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5601002694 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
127 FOREST AVE |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48067-1843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1750917811 | Sonia B Shah-gonzalez | Case Management | 830 E Fourth St, #1, Royal Oak, MI 48067 | 2020-03-19 |
| 1568022960 | Woodo Pharmacy LLC | Pharmacy | 909 E 11 Mile Rd, Royal Oak, MI 48067 | 2019-06-18 |
| 1093217564 | Sharon Diane Malinowski | Occupational Therapist | 4949 Coolidge Hwy Section E, Adult Neuro Ot, Royal Oak, MI 48067 | 2018-03-01 |
| 1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
| 1629420179 | Christine Paige | Homeopath | 1112 Catalpa, Royal Oak, MI 48067 | 2016-07-08 |
| 1104277045 | Rppc Labs, LLC | Clinical Medical Laboratory | 26154 Woodward Ave Ste 5, Royal Oak, MI 48067 | 2016-06-22 |
| 1346606423 | Thomas Michalos | Counselor | 402 S. Lafayette, Royal Oak, MI 48067 | 2016-01-05 |
| 1508234212 | Valetta Aldridge | Registered Nurse | 28000 Woodward, Royal Oak, MI 48067 | 2015-09-11 |
| Find all providers in zip 48067 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720483670 | Tricia Campbell | Physician Assistant | 605 Helene Ave, Royal Oak, MI 48067 | 2014-11-04 |
| 1023130853 | Mobile Medical Consultant Pllc | Physician Assistant | 620 S Dorchester Ave, Royal Oak, MI 48067-4048 | 2007-04-04 |
| 1851493241 | Angeline A Carter | Physician Assistant | 2674 Bembridge Rd, Royal Oak, MI 48073-2921 | 2006-09-05 |
| 1922094689 | Kenneth Wayne Gahry | Physician Assistant | 5130 Coolidge Hwy, Royal Oak, MI 48073-1001 | 2005-09-27 |
| 1902443047 | Brad Vamplew | Physician Assistant | 31157 Woodward Ave, Royal Oak, MI 48073-0996 | 2019-12-09 |
| 1770124208 | Ashley Meerschaert | Physician Assistant | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-10-07 |
| 1871058065 | Zeinab Joumaa Naji | Physician Assistant | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2019-02-01 |
| 1497269781 | Kristin Joy Welbourn | Physician Assistant | 3600 W 13 Mile Rd, Royal Oak, MI 48073-6711 | 2017-11-22 |
| 1982144150 | Chelsea Foster | Physician Assistant | 3577 W 13 Mile Rd, Suite 204, Royal Oak, MI 48073-6710 | 2017-03-07 |
| 1043754286 | Taylor Dillman | Physician Assistant | 1010 N Campbell Rd, Suite 3, Royal Oak, MI 48067-1570 | 2016-12-07 |
| Find all providers in ROYAL OAK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.