Healthcare Provider Details

I. General information

NPI: 1184676686
Provider Name (Legal Business Name): JAMES F. BURRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 DAVENPORT ST NW
WASHINGTON DC
20016-4314
US

IV. Provider business mailing address

4803 DAVENPORT ST NW
WASHINGTON DC
20016-4314
US

V. Phone/Fax

Practice location:
  • Phone: 202-273-8540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD12757
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD12757
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code208U00000X
TaxonomyClinical Pharmacology Physician
License NumberMD12757
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: