Provider Demographics
NPI:1891840138
Name:MD MEDICAL WRITING, LLC
Entity Type:Organization
Organization Name:MD MEDICAL WRITING, LLC
Other - Org Name:SUSAN F BURROUGHS M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:BURROUGHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-265-2655
Mailing Address - Street 1:15 PALOMBA DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3853
Mailing Address - Country:US
Mailing Address - Phone:860-265-2655
Mailing Address - Fax:860-265-2699
Practice Address - Street 1:15 PALOMBA DR
Practice Address - Street 2:SUITE 11
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3853
Practice Address - Country:US
Practice Address - Phone:860-265-2655
Practice Address - Fax:860-265-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT030948207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DF6688OtherRAIL ROAD MEDICARE
C03659Medicare PIN
DF6688OtherRAIL ROAD MEDICARE