Individual
LANCE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8100 SANDPIPER CIR, SUITE 210, NOTTINGHAM, MD 21236-4991
(443) 693-7246
(866) 442-5401
Mailing address
7920 MCDONOGH RD, SUITE 201, OWINGS MILLS, MD 21117-5273
(443) 693-7246
(866) 902-5997
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005267
MD
Other
Enumeration date
11/05/2013
Last updated
11/06/2014
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