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Organization
GARY BURTON, M.D., LLC
Active
Organization
GARY BURTON, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOYCE MARIALICE BURTON PH.D. (CHIEF OPERATING OFFICER)
(301) 441-3375
Entity
Organization
Contact information
Practice address
4000 MITCHELLVILLE RD, SUITE 306, BOWIE, MD 20716-3104
(301) 441-3375
(301) 441-4711
Mailing address
4000 MITCHELLVILLE RD, SUITE 306, BOWIE, MD 20716-3104
(301) 441-3375
(301) 441-4711
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
D0052974
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014200000
—
MD
01
—
490057
MEDICARE
MD
Enumeration date
02/03/2011
Last updated
02/03/2011
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