MEDICARE: NINA CAMILLE BURRUSS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	D0100939	MD
2	2084P0804X	Child & Adolescent Psychiatry Physician	D0100939	MD

General Provider Information

NPI Number	:	1598386278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NINA CAMILLE BURRUSS MD

Provider Business Mailing Address
First Line	:	4905 DEL RAY AVE STE 210
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2559
Country	:	US
Telephone Number	:	301-901-8924
Fax Number	:	301-709-6282

Provider Business Practice Location Address
First Line	:	4905 DEL RAY AVE STE 210
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2559
Country	:	US
Telephone Number	:	301-901-8924
Fax Number	:	301-709-6282

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	01/19/2026

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