=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366514002
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SCOTT COURTNEY BURR M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2006
-----------------------------------------------------
Last Update Date | 02/28/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7002 QUISINBERRY WAY
-----------------------------------------------------
City | BOWIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20720-4312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-633-5733
-----------------------------------------------------
Fax | 301-352-0559
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7002 QUISINBERRY WAY
-----------------------------------------------------
City | BOWIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20720-4312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-633-5733
-----------------------------------------------------
Fax | 301-352-0559
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | MD20226
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | D46628
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------