Burgess, Theresa Catherine

Burgess, Theresa Catherine is an sole proprietor health care provider with primary practice located at 725 Highland Ave Suite 100, Winston Salem NC 27101-4180. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Burgess, Theresa Catherine can be contacted via phone (336) 607-8523.

Contact Information

Primary practice address
725 Highland Ave Suite 100 Winston Salem NC 27101-4180
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 28950 North Carolina

Profile Details

NPI number 1477544377
LBN Legal business name Burgess, Theresa Catherine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2005
Last updated Nov 18th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477544377 NPPES
North Carolina MEDICAID 891114P

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