Individual
KISHA LASHAUN BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(404) 756-1368
(404) 756-1313
Mailing address
12470 SW 185TH ST, MIAMI, FL 33177-3186
(305) 299-2508
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
97697
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2020
Last updated
01/30/2024
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