Provider Demographics
NPI:1528140464
Name:BURMAN & ZUCKERBROD OPHTHALMOLOGY ASSOCIATES, P.C
Entity type:Organization
Organization Name:BURMAN & ZUCKERBROD OPHTHALMOLOGY ASSOCIATES, P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:BURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-332-4544
Mailing Address - Street 1:43996 WOODWARD AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5028
Mailing Address - Country:US
Mailing Address - Phone:248-332-4544
Mailing Address - Fax:248-332-2716
Practice Address - Street 1:43996 WOODWARD AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5028
Practice Address - Country:US
Practice Address - Phone:248-332-4544
Practice Address - Fax:248-332-2716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP07250OtherMEDICARE PTAN
MIOP07250OtherMEDICARE PTAN