Healthcare Provider Details

I. General information

NPI: 1215799440
Provider Name (Legal Business Name): KEITH STEVEN BUEHLER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

IV. Provider business mailing address

363 HIGHLAND AVE
FALL RIVER MA
02720-3703
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-7014
  • Fax:
Mailing address:
  • Phone: 508-973-7014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2365955
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: