Individual
WANDA G BURDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 414-4800
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
509
WV
Other
Enumeration date
04/23/2008
Last updated
01/01/2023
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