Burke, Demetrius
Burke, Demetrius is an sole proprietor health care provider with primary practice located at 1111 40Th St Se , Grand Rapids MI 49508-6084. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Burke, Demetrius can be contacted via phone (616) 318-5873.Contact Information
Primary practice address
1111 40Th St Se
Grand Rapids MI 49508-6084
Phone: (616) 318-5873
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X |
Profile Details
| NPI number | 1912510033 |
|---|---|
| LBN Legal business name | Burke, Demetrius |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 28th, 2020 |
| Last updated | May 4th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912510033 | NPPES |
| Michigan | MEDICAID | 1912510033 |
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