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Organization

COLUMBIA DERMATOLOGY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSICA RAE BURGY M.D. (PHYSICIAN)
(304) 894-4582
Entity
Organization

Contact information

Practice address
2241 BUSH RIVER RD, COLUMBIA, SC 29210-5626
(304) 894-4582
Mailing address
2241 BUSH RIVER RD, COLUMBIA, SC 29210-5626
(304) 894-4582

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
02/24/2015
Last updated
06/11/2015
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