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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