Healthcare Provider Details

I. General information

NPI: 1013069186
Provider Name (Legal Business Name): DAVID DONALD BUETHE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7614 JACQUE ROAD SUITE A
HUDSON FL
34607
US

IV. Provider business mailing address

7614 JACQUE ROAD SUITE A
HUDSON FL
34607
US

V. Phone/Fax

Practice location:
  • Phone: 727-862-8548
  • Fax: 727-863-4530
Mailing address:
  • Phone: 727-862-8548
  • Fax: 727-863-4530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME110201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: