Individual
ELIZABETH BURBAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 310, COLUMBIA, SC 29203-6883
(803) 434-8450
(803) 758-0137
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7788
GA
363A00000X
Physician Assistant
Primary
PA2709
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2945PA
—
SC
Enumeration date
11/10/2015
Last updated
05/03/2019
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