Individual
JANELL LESLIE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
900 CATON AVE, BALTIMORE, MD 21229-5201
(667) 234-2414
Mailing address
2411 W BELVEDERE AVE, SUITE 206, BALTIMORE, MD 21215-5228
(410) 601-8318
(410) 601-8576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0004669
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52-0486540
TYPE 1
MD
Enumeration date
02/16/2012
Last updated
12/28/2023
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