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1558309062
KEITH C. BURGESS
BALTIMORE, MD
NPI
1558309062
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MD C01300)
Enumeration Date
2006-06-04
Last Update Date
2007-07-11
Business Address
-- KEITH C. BURGESS PA
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239-2905
Phone number: 410-532-4040
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Mailing Address
-- KEITH C. BURGESS PA
307 S EVERGREEN AVE
WOODBURY, NJ 08096-2739
Phone number: 856-686-4300
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