Healthcare Provider Details

I. General information

NPI: 1427324433
Provider Name (Legal Business Name): ROBERT CALEB BUEGE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2012
Last Update Date: 09/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 CEDAR GROVE RD STE 20
SHEPHERDSVILLE KY
40165-8592
US

IV. Provider business mailing address

1707 CEDAR GROVE RD STE 20
SHEPHERDSVILLE KY
40165-8592
US

V. Phone/Fax

Practice location:
  • Phone: 502-215-5090
  • Fax:
Mailing address:
  • Phone: 502-215-5090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number47693
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: