Basic Information
| Provider Information | |||||||||
| NPI: | 1619035524 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURNER | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | LEROY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 EAST JEFFERSON STREET PPQA MEDICARE COMP. UNIT 6 | ||||||||
| Address2: | KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018166660 | ||||||||
| FaxNumber: | 3018166308 | ||||||||
| Practice Location | |||||||||
| Address1: | 1011 NORTH CAPITOL STREET NE | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200024236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2028985104 | ||||||||
| FaxNumber: | 2028985474 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 06/22/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0101019813 | VA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | D54601 | MD | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | MD31536 | WA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.