Healthcare Provider Details

I. General information

NPI: 1972824340
Provider Name (Legal Business Name): MUHAMMAD HAROON BURHANULLAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2010
Last Update Date: 12/01/2022
Certification Date: 12/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 ALPHA COMMONS DR. 4TH FL # 417 JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
BALTIMORE MD
21224
US

IV. Provider business mailing address

13822 MILL CREEK CT
CLARKSVILLE MD
21029-1040
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-7428
  • Fax:
Mailing address:
  • Phone: 410-550-1089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number29205
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD456179
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number281998
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD80340
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA166326
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberD80340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: