Healthcare Provider Details

I. General information

NPI: 1700960069
Provider Name (Legal Business Name): ANNE ENANGA BURNLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE EKITI MD

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 LLEWELLYN AVE
FORT MEADE MD
20755-5800
US

IV. Provider business mailing address

5207 CHURCH RD
BOWIE MD
20720-4916
US

V. Phone/Fax

Practice location:
  • Phone: 301-677-8402
  • Fax:
Mailing address:
  • Phone: 301-377-4324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD0060484
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: