Individual
REBECCA CORLEY BURNSIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2728 SUNSET BLVD STE 104, WEST COLUMBIA, SC 29169-4838
(803) 256-0464
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL36980
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
36980
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME131423
FL
207RP1001X
Pulmonary Disease Physician
Primary
36980
SC
207RP1001X
Pulmonary Disease Physician
ME131423
FL
Other
Enumeration date
06/09/2014
Last updated
02/26/2025
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