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NPI Code Detail

MEDICARE: BRUCE A BUCHAN CRNA

MEDICARE: BRUCE A BUCHAN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist4704108877MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639164668
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE A BUCHAN CRNA
Provider Business Mailing Address
First Line : 4100 PARK FOREST DR
Second Line : SUITE 210
City : TRAVERSE CITY
State : MI
Zip : 49684-7331
Country : US
Telephone Number : 231-935-5770
Fax Number : 231-935-5878
Provider Business Practice Location Address
First Line : 4100 PARK FOREST DR
Second Line : SUITE 210
City : TRAVERSE CITY
State : MI
Zip : 49684-7331
Country : US
Telephone Number : 231-935-5770
Fax Number : 231-935-5878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 07/08/2007

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Directions to “ BRUCE A BUCHAN CRNA” Practice Location

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