Individual
DR. GREGORY M BURNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 W PRATT ST, BALTIMORE, MD 21223-2679
(443) 462-3400
(443) 462-3091
Mailing address
1001 W PRATT ST, BALTIMORE, MD 21223-2679
(443) 462-3400
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
D0089668
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XB9390751
SAMHSA MAT WAIVER
—
Enumeration date
06/07/2012
Last updated
03/07/2023
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