Provider Demographics
NPI:1063453801
Name:BURNS, CAROLYN ADELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ADELL
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 780125
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0125
Mailing Address - Country:US
Mailing Address - Phone:804-922-4844
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:9000 STONY POINT PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1900
Practice Address - Country:US
Practice Address - Phone:804-560-8920
Practice Address - Fax:804-998-1255
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043414207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA313668OtherMAMSI
VA110054802OtherRAILROAD MEDICARE
VA276187OtherANTHEM/VA HEALTHKEEPERS
VA77728OtherANTHEM/VA HEALTHKEEPERS
VA276221OtherANTHEM/VA HEALTHKEEPERS
VA4323068OtherAETNA/US HEALTHCARE
VA6083561Medicaid
VA103808OtherANTHEM/VA HEALTHKEEPERS
VA27413300OtherFEDERAL BLACK LUNG
VA276288OtherANTHEM/VA HEALTHKEEPERS
VA44213OtherSENTARA HEALTH/OPTIMA
VA1891603OtherCIGNA
VA276257OtherANTHEM/VA HEALTHKEEPERS
VA276341OtherANTHEM/VA HEALTHKEEPERS
VA56280OtherSOUTHERN HEALTH
VA727072OtherAETNA/US HEALTHCARE HMO
VAE48560Medicare UPIN
110004504Medicare PIN