Burnside, Edward Clark

Burnside, Edward Clark is an individual health care provider with primary practice located at 1028 Ewall St , Mt Pleasant SC 29464-3046. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Burnside, Edward Clark can be contacted via phone (843) 573-0499.

Contact Information

Primary practice address
1028 Ewall St Mt Pleasant SC 29464-3046
Phone: (843) 573-0499
Fax: (843) 388-6292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X TL 1511 South Carolina

Profile Details

NPI number 1639492952
LBN Legal business name Burnside, Edward Clark
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2010
Last updated Mar 2nd, 2010 - about 14 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 1639492952 NPPES
South Carolina Other TL 1511 SC STATE TEMP LICENSE

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