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NPI Code Detail

MEDICARE: ALEXIS A BUZUMA DO

MEDICARE: ALEXIS A BUZUMA DO
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
1207Q00000XFamily Medicine Physician9500852NC

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 : 1982682993
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS A BUZUMA DO
Provider Business Mailing Address
First Line : 2000 FRONTIS PLAZA BLVD STE 200
Second Line : ATTN FORSYTH MEDICAL GROUP
City : WINSTON SALEM
State : NC
Zip : 27103-5616
Country : US
Telephone Number : 336-277-2436
Fax Number :
Provider Business Practice Location Address
First Line : 291 BROAD ST
Second Line :
City : KERNERSVILLE
State : NC
Zip : 27284-2932
Country : US
Telephone Number : 336-993-8181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 07/08/2007

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Directions to “ ALEXIS A BUZUMA DO” Practice Location

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