Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 0101241760 | VA |
NPI | 1952514226 |
---|---|
Provider Name | Autumn Ford Burnette |
First Address | Washington, DC 20060-0001 |
Second Address | Washington, DC 20060-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 23/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1952514226 | (05) | VA |