Healthcare Provider Details

I. General information

NPI: 1124548284
Provider Name (Legal Business Name): CHARLES SCOTT BUESS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/14/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 PIPER ST STE U340
ANCHORAGE AK
99508-6904
US

IV. Provider business mailing address

9161 CHAPELLE CIRCLE
ANCHORAGE AK
99507
US

V. Phone/Fax

Practice location:
  • Phone: 907-562-0321
  • Fax:
Mailing address:
  • Phone: 316-207-6599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberT3929
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number216923
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: