Healthcare Provider Details

I. General information

NPI: 1598293318
Provider Name (Legal Business Name): BONNIE ANN BUECHEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2803 ROSLYN ST
DENVER CO
80238-2624
US

IV. Provider business mailing address

76 CREST DR
SOUTH ORANGE NJ
07079-1037
US

V. Phone/Fax

Practice location:
  • Phone: 303-403-6300
  • Fax:
Mailing address:
  • Phone: 973-769-7068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0067339
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: