Individual
DR. ROXANNE L BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
11030 S TRYON ST, STE 308, CHARLOTTE, NC 28273-6545
(704) 504-1004
(704) 504-0007
Mailing address
11030 S TRYON ST, STE 308, CHARLOTTE, NC 28273-6545
(704) 504-1004
(704) 504-0007
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
NC461
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
NC461
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081AV
BCBS
NC
01
—
5564660001
CIGNA GOVERNMENT SERVICES
NC
05
—
89081AV
—
NC
05
—
NPD461
—
SC
Enumeration date
11/30/2007
Last updated
02/18/2021
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