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
Phone: (336) 607-8523
Fax:
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1477544377 | NPPES |
North Carolina | MEDICAID | 891114P |
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