Healthcare Provider Details

I. General information

NPI: 1154692671
Provider Name (Legal Business Name): KAI U BUECH CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8450 NORTHWEST BLVD
INDIANAPOLIS IN
46278-1381
US

IV. Provider business mailing address

8450 NORTHWEST BLVD
INDIANAPOLIS IN
46278-1381
US

V. Phone/Fax

Practice location:
  • Phone: 317-802-2000
  • Fax: 317-802-2170
Mailing address:
  • Phone: 317-802-2000
  • Fax: 317-802-2170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: