Healthcare Provider Details

I. General information

NPI: 1669403341
Provider Name (Legal Business Name): SAMEER BURMAWALA ISMAILJEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1460
US

IV. Provider business mailing address

310 ALDERWOOD DR
GAITHERSBURG MD
20878-2686
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7000
  • Fax:
Mailing address:
  • Phone: 937-620-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35083321
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberV2379
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD0082137
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: