Provider Demographics
NPI:1508209362
Name:BURTOFF, BRUCE D (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:D
Last Name:BURTOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:VA
Mailing Address - Zip Code:22960
Mailing Address - Country:US
Mailing Address - Phone:703-519-8080
Mailing Address - Fax:703-519-8084
Practice Address - Street 1:108 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:VA
Practice Address - Zip Code:22960
Practice Address - Country:US
Practice Address - Phone:703-519-8080
Practice Address - Fax:703-519-8084
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101030428174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist