Healthcare Provider Details

I. General information

NPI: 1669975355
Provider Name (Legal Business Name): SARAH ELIZABETH BURCHETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2018
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8730 STONY POINT PKWY STE 120
RICHMOND VA
23235-1959
US

IV. Provider business mailing address

9101 STONY POINT PKWY APT 1108
RICHMOND VA
23235-2002
US

V. Phone/Fax

Practice location:
  • Phone: 804-775-4559
  • Fax:
Mailing address:
  • Phone: 434-607-3265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number0110005981
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: