Healthcare Provider Details
I. General information
NPI: 1225011018
Provider Name (Legal Business Name): ERIC DAVID BUCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/25/2005
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
257 LOW ST CHILDREN'S HEALTH CARE, INC.
NEWBURYPORT MA
01950-3556
US
IV. Provider business mailing address
257 LOW ST CHILDREN'S HEALTH CARE, INC.
NEWBURYPORT MA
01950-3556
US
V. Phone/Fax
- Phone: 978-465-7121
- Fax:
- Phone: 978-465-7121
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 210640 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: