Healthcare Provider Details

I. General information

NPI: 1548182579
Provider Name (Legal Business Name): MJM ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 LOCKWOOD DR STE 260
SILVER SPRING MD
20901-1559
US

IV. Provider business mailing address

PO BOX 235
CABIN JOHN MD
20818-0235
US

V. Phone/Fax

Practice location:
  • Phone: 202-964-1160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: LINDY BURRUSS
Title or Position: OFFICE MANAGER
Credential:
Phone: 202-964-1160