Organization
MAIN STREET MED CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES ONEIL BURNS DO (MEDICAL DIRECTOR CO OWNER)
(410) 548-2700
Entity
Organization
Contact information
Practice address
951A MOUNT HERMON RD, SALISBURY, MD 21804-5105
(410) 548-2700
(410) 548-2608
Mailing address
951A MOUNT HERMON RD, SALISBURY, MD 21804-5105
(410) 548-2700
(410) 548-2608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M36690
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL15MA
BLUE SHIELD
—
01
—
W0520001
BLUE CHOICE
DC
Enumeration date
01/27/2006
Last updated
08/22/2020
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