Healthcare Provider Details

I. General information

NPI: 1073501367
Provider Name (Legal Business Name): MICHAEL SCOTT BUEBEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 03/07/2023
Certification Date: 04/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N FIR AVE
SILER CITY NC
27344-3071
US

IV. Provider business mailing address

311 N FIR AVE
SILER CITY NC
27344-3071
US

V. Phone/Fax

Practice location:
  • Phone: 919-742-6032
  • Fax: 919-663-3018
Mailing address:
  • Phone: 919-742-6032
  • Fax: 919-663-3018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2005-01529
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: