Individual
DR. MAUREEN ALICE BURBAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
124 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 241-1040
Mailing address
124 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 241-1040
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
TL33500
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD33500
SOUTH CAROLINA MEDICAL LICENSE
SC
Enumeration date
10/28/2008
Last updated
11/30/2012
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