Provider Demographics
NPI:1720468119
Name:BURKE, MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2001 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1378
Mailing Address - Country:US
Mailing Address - Phone:517-337-0316
Mailing Address - Fax:517-337-1779
Practice Address - Street 1:3600 CAPITAL AVE SW STE 203
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9393
Practice Address - Country:US
Practice Address - Phone:269-979-6383
Practice Address - Fax:269-979-6381
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301107655207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301117342OtherSTATE LICENSE