Provider Demographics
NPI:1689935256
Name:BURTON, JALAN W (MD, MPH))
Entity Type:Individual
Prefix:
First Name:JALAN
Middle Name:W
Last Name:BURTON
Suffix:
Gender:F
Credentials:MD, MPH)
Other - Prefix:
Other - First Name:JALAN
Other - Middle Name:M
Other - Last Name:WASHINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3709 S STREET SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-2359
Mailing Address - Country:US
Mailing Address - Phone:202-930-9669
Mailing Address - Fax:202-873-2242
Practice Address - Street 1:3709 S STREET SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-2359
Practice Address - Country:US
Practice Address - Phone:202-930-9669
Practice Address - Fax:202-873-2242
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD043074208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics