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General NPI Number Information
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NPI Number | 1326039587
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Entity Type | Individual
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Provider Name | ALFRED C BURRIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1328 SOUTHERN AVE SE 214
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City | WASHINGTON
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State | DC
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Zip | 20032-4689
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Country | US
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Telephone | 202-562-4310
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Fax | 202-563-3935
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Provider Business Mailing Address
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Address Line | 1328 SOUTHERN AVE SE 214
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City | WASHINGTON
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State | DC
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Zip | 20032-4689
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Country | US
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Telephone | 202-562-4310
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Fax | 202-563-3935
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | D0024996
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License Number State | MD
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