Healthcare Provider Details

I. General information

NPI: 1679977078
Provider Name (Legal Business Name): CAROLINE JILL BUEHLER M.S, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 MEDICAL PARKWAY,, ANNAPOLIS DERMATOLOGY ASSOCIATES SUITE 630
ANNAPOLIS MD
21401
US

IV. Provider business mailing address

2521 FAIT AVE
BALTIMORE MD
21224-3720
US

V. Phone/Fax

Practice location:
  • Phone: 504-920-7613
  • Fax:
Mailing address:
  • Phone: 504-920-7613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1120856
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: