MEDICARE: DR. HENRY E BURGESS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	C159147	CA
2	207Q00000X	Family Medicine Physician	81686	SC
3	207Q00000X	Family Medicine Physician	E-11833	AR
4	207Q00000X	Family Medicine Physician	201803048	NC
5	207Q00000X	Family Medicine Physician	0101230868	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080171551	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	441912	OTHER		ANTHEM
3	441913	OTHER	VA	ANTHEM
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	441914	OTHER		ANTHEM

General Provider Information

NPI Number	:	1376516260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY E BURGESS MD

Provider Business Mailing Address
First Line	:	674 LEES GAP RD
Second Line	:
City	:	FINCASTLE
State	:	VA
Zip	:	24090-3869
Country	:	US
Telephone Number	:	540-682-3082
Fax Number	:	540-779-7889

Provider Business Practice Location Address
First Line	:	405 E LABURNUM AVE STE 3
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23222-2134
Country	:	US
Telephone Number	:	540-200-8821
Fax Number	:	540-779-7889

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	01/22/2025

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Directions to “ DR. HENRY E BURGESS MD” Practice Location

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