Individual
DR. THERESA CATHERINE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 HIGHLAND AVE, SUITE 100, WINSTON SALEM, NC 27101-4180
(336) 607-8523
Mailing address
3908 LEINBACH DR, WINSTON SALEM, NC 27106-1619
(336) 416-6796
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28950
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891114P
—
NC
Enumeration date
10/31/2005
Last updated
11/18/2020
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