Provider Demographics
NPI:1306548789
Name:BURGESS, ANNE CAROLINE (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:CAROLINE
Last Name:BURGESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:CAROLINE
Other - Last Name:POINDEXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 ALBERT SABIN WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0531
Mailing Address - Country:US
Mailing Address - Phone:513-558-6356
Mailing Address - Fax:513-558-0995
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-558-6356
Practice Address - Fax:513-558-0995
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH57.254175207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program