Provider Demographics
NPI:1699723957
Name:BURAS, JON ANTHONY (MD PHD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:ANTHONY
Last Name:BURAS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HOLLY HILL CIR
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-1728
Mailing Address - Country:US
Mailing Address - Phone:781-771-3104
Mailing Address - Fax:
Practice Address - Street 1:18 HOLLY HILL CIR
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-1728
Practice Address - Country:US
Practice Address - Phone:781-771-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM-2231207P00000X
MA157461207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3209083Medicaid
MAH16372Medicare UPIN
MAA31086Medicare ID - Type Unspecified