MEDICARE: JONATHAN BURNS M.D.

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	241264	MA

General Provider Information

NPI Number	:	1396897096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN BURNS M.D.

Provider Business Mailing Address
First Line	:	EVERETT FAMILY HEALTH CENTER
Second Line	:	391 BROADWAY
City	:	EVERETT
State	:	MA
Zip	:	02149-5067
Country	:	US
Telephone Number	:	617-575-5850
Fax Number	:

Provider Business Practice Location Address
First Line	:	337 SOMERVILLE AVE
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02143-2914
Country	:	US
Telephone Number	:	617-665-3370
Fax Number	:

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	11/11/2015

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