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GARY A BURKHART PH.D.

Clinical Neuropsychologist

Grand Rapids, Michigan

Provider NPI: 1598712184

Provider Information:
 GARY A BURKHART PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
300 68TH ST SE  GRAND RAPIDS, MI 49548 US
Tel: 616-455-5000  Fax: --

Business Mailing Address:
300 68TH ST SE  GRAND RAPIDS, MI 49548 US
Tel: 616-455-5000  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
MI6301005717
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MI6301005717

Other Provider Identifiers:

IssuerNumberStateType
MEDICARED16189055MI04
S82776MI02
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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