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NPI Code Detail

MEDICARE: ANTONIO BUENDIA MD

MEDICARE: ANTONIO BUENDIA MD
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
12085R0202XDiagnostic Radiology PhysicianMD030587EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
44433688OTHERPABLUE SHIELD

General Provider Information

NPI Number : 1740262971
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONIO BUENDIA MD
Provider Business Mailing Address
First Line : PO BOX 1645
Second Line :
City : MORGANTOWN
State : WV
Zip : 26507-1645
Country : US
Telephone Number : 304-598-2291
Fax Number : 304-598-2293
Provider Business Practice Location Address
First Line : 350 N 11TH ST
Second Line :
City : SUNBURY
State : PA
Zip : 17801-1611
Country : US
Telephone Number : 570-286-3472
Fax Number : 570-286-3397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 02/28/2011

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Directions to “ ANTONIO BUENDIA MD” Practice Location

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