Individual
DR. LATASHA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 E CHEVES ST STE 400, FLORENCE, SC 29506-2649
(843) 777-7341
(843) 777-7345
Mailing address
800 E CHEVES ST STE 400, FLORENCE, SC 29506-2649
(843) 777-7341
(843) 777-7345
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049877
GA
207QA0505X
Adult Medicine Physician
92875
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000915846D
—
GA
Enumeration date
11/12/2006
Last updated
02/28/2025
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