Provider Demographics
NPI:1588645998
Name:BURGBACHER, JAMES STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:STANLEY
Last Name:BURGBACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 MAIN ST
Mailing Address - Street 2:STE. 201
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-1828
Mailing Address - Country:US
Mailing Address - Phone:434-799-3037
Mailing Address - Fax:434-793-0116
Practice Address - Street 1:990 MAIN ST
Practice Address - Street 2:STE. 201
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-1828
Practice Address - Country:US
Practice Address - Phone:434-799-3037
Practice Address - Fax:434-793-0116
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010198122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA060321OtherANTHEM BCBS PROVIDER NO.
VAE55785Medicare UPIN