Healthcare Provider Details

I. General information

NPI: 1689935256
Provider Name (Legal Business Name): JALAN W BURTON M.D., M.P.H.)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JALAN M WASHINGTON

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 S STREET SE
WASHINGTON DC
20020-2359
US

IV. Provider business mailing address

3709 S STREET SE
WASHINGTON DC
20020-2359
US

V. Phone/Fax

Practice location:
  • Phone: 202-930-9669
  • Fax: 202-873-2242
Mailing address:
  • Phone: 202-930-9669
  • Fax: 202-873-2242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD043074
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: