Provider Demographics
NPI:1548485352
Name:BURKMAN, MARNIE A (MD)
Entity type:Individual
Prefix:
First Name:MARNIE
Middle Name:A
Last Name:BURKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 APRILL DR STE 4
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-1956
Mailing Address - Country:US
Mailing Address - Phone:734-913-0345
Mailing Address - Fax:734-913-0345
Practice Address - Street 1:107 APRILL DR STE 4
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-1956
Practice Address - Country:US
Practice Address - Phone:734-913-0345
Practice Address - Fax:734-913-0345
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO451812084P0800X
MI43010955152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry