Provider Demographics
NPI:1326039587
Name:BURRIS, ALFRED C (MD)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:C
Last Name:BURRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1328 SOUTHERN AVE SE
Mailing Address - Street 2:214
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-4689
Mailing Address - Country:US
Mailing Address - Phone:202-562-4310
Mailing Address - Fax:202-563-3935
Practice Address - Street 1:1328 SOUTHERN AVE SE
Practice Address - Street 2:214
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4689
Practice Address - Country:US
Practice Address - Phone:202-562-4310
Practice Address - Fax:202-563-3935
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0024996207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC409534B99Medicare PIN
DC559999Medicare PIN