Mark E Burroughs, PHARMD

Individual provider Active NPI Pharmacist · Washington, DC

NPI 1023095759 · NPPES record last updated May 8, 2008

Key facts

NPI
1023095759
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
29498 (TX)
Practice address
Uscg HQ, Comdt (CG-1122)
2100 2ND Street, RM 5314
Washington, DC 20593-0001
Phone
(202) 267-0694
Fax
(202) 267-4685
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
29498TXMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 29498 TX Yes

Addresses

Primary practice location

Uscg HQ, Comdt (CG-1122)
2100 2ND Street, RM 5314
Washington, DC 20593-0001

Mailing address

Uscg HQ, Comdt (CG-1122)
2100 2ND Street, RM 5314
Washington, DC 20593-0001
Phone (202) 267-0694

Other providers in Washington, DC

All providers in Washington, DC · Pharmacist in District of Columbia

Sources for this page

Verify at the official NPI Registry.