Individual
MARY S BURR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN
Contact information
Practice address
1302 BELLONA AVE, LUTHERVILLE, MD 21093-5425
(410) 328-6749
(410) 296-3120
Mailing address
PO BOX 62063, BALTIMORE, MD 21264-2063
(410) 706-5181
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
R084105
MD
363LP0200X
Pediatric Nurse Practitioner
Primary
R084105
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401944000
—
MD
Enumeration date
06/12/2006
Last updated
11/23/2015
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