Provider Demographics
NPI:1750478301
Name:BURNO, DELMENA GUNTER (PA-C ,MAS, BA,,BSC)
Entity Type:Individual
Prefix:MRS
First Name:DELMENA
Middle Name:GUNTER
Last Name:BURNO
Suffix:
Gender:F
Credentials:PA-C ,MAS, BA,,BSC
Other - Prefix:MISS
Other - First Name:DELMENA
Other - Middle Name:MERCEDES
Other - Last Name:GUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1602 FAIRLAKES PL
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3103
Mailing Address - Country:US
Mailing Address - Phone:301-350-8139
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:202-745-2209
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA15363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical