Healthcare Provider Details

I. General information

NPI: 1871128389
Provider Name (Legal Business Name): ASHTON BURRUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHTON DANIEL

II. Dates (important events)

Enumeration Date: 03/04/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-2468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number64122
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: