Organization
CLEMSON PSYCHIATRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN A BURBAGE M.D. (PRESIDENT)
(864) 653-4112
Entity
Organization
Contact information
Practice address
398 COLLEGE AVE, CLEMSON, SC 29631-1432
(864) 653-4112
(864) 653-4129
Mailing address
398 COLLEGE AVE, CLEMSON, SC 29631-1432
(864) 653-4112
(864) 653-4129
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
33500
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33500
LICENSE #
SC
Enumeration date
09/01/2011
Last updated
09/01/2011
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