| Michael Burroughs PLLC | |
|
555 S Mangum St Ste 100 Durham NC 27701-4689 | |
| (984) 377-2877 | |
| Not Available |
| Full Name | Michael Burroughs PLLC |
|---|---|
| Speciality | Social Worker |
| Location | 555 S Mangum St Ste 100, Durham, North Carolina |
| Authorized Official Name and Position | Jon Michael Burroughs (OWNER) |
| Authorized Official Contact | 9843772877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Burroughs PLLC 555 S Mangum St Ste 100 Durham NC 27701-4689 | Michael Burroughs PLLC 555 S Mangum St Ste 100 Durham NC 27701-4689 Ph: (984) 377-2877 |
| NPI Number | 1285302166 |
|---|---|
| Provider Enumeration Date | 09/03/2021 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Medicare PECOS PAC ID | 7113316597 |
|---|---|
| Medicare Enrollment ID | O20211105002604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285302166 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
| Provider Name | Jon Michael Burroughs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619026366 PECOS PAC ID: 2163567710 Enrollment ID: I20100306000247 |
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