Michael Burgess
Technician, Personal Care Attendant in Petersburg, WV. Individual provider (NPI-1).
NPI number1104739713
StatusActive
Last updated in NPPESSep 24, 2026
Details
- NPI
- 1104739713
- Entity type
- Individual (NPI-1)
- Name
- Michael Burgess
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2026
- Certification date
- Sep 24, 2026
- Last updated
- Sep 24, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
12 Maple Hill Ave Ste 1Petersburg, WV 26847-1547
Phone 304-242-8404
Mailing address
198 Mernie Ours RdPetersburg, WV 26847-8892
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