Provider Demographics
NPI:1952358459
Name:ROGERS C. BURLTON, M.D. CHARTERED
Entity Type:Organization
Organization Name:ROGERS C. BURLTON, M.D. CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGERS
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BURLTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-871-1733
Mailing Address - Street 1:13800 LOREE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2929
Mailing Address - Country:US
Mailing Address - Phone:301-871-1733
Mailing Address - Fax:301-871-9592
Practice Address - Street 1:13800 LOREE LN
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-2929
Practice Address - Country:US
Practice Address - Phone:301-871-1733
Practice Address - Fax:301-871-9592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD04506261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC6783000OtherCAREFIRST BCBSDC
MD246823OtherMDIPA
MD246823OtherALLIANCE
MD512666OtherNCPPO
MD1608RCBOtherCAREFIRSDTBCBSMD
MD246823OtherOPTIMUM CHOICE
MD246823OtherALLIANCE
MD512666OtherNCPPO