Individual
ANDREW JAY BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1809 WADE HAMPTON BLVD, SUITE 120, GREENVILLE, SC 29609-4041
(864) 522-5000
(864) 241-9275
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34858
SC
208000000X
Pediatrics Physician
34858
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
348582
—
SC
Enumeration date
06/12/2012
Last updated
05/23/2021
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