Healthcare Provider Details

I. General information

NPI: 1356566103
Provider Name (Legal Business Name): ANNA KATHRYN RYE BURCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA KATHRYN RYE MD

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 RICHLAND MEDICAL PARK DR STE 210
COLUMBIA SC
29203-6859
US

IV. Provider business mailing address

PO BOX 743904
ATLANTA GA
30374-3904
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-7995
  • Fax: 803-434-8606
Mailing address:
  • Phone: 803-434-7950
  • Fax: 803-434-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25198
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number25198
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: