Individual
MR. CARLOS FERNANDO BURGOA-RIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2050 GRIFFITH RD, WINSTON SALEM, NC 27103-5509
(336) 293-4510
(336) 293-4512
Mailing address
3555 SYCAMORE TRL APT 205, WINSTON SALEM, NC 27103-6862
(336) 776-0966
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-02248
NC
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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