Healthcare Provider Details

I. General information

NPI: 1285680066
Provider Name (Legal Business Name): JOHN ERNST BUENTING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 THE VILLAGE OVERLOOK
SYLVA NC
28779-2616
US

IV. Provider business mailing address

38 THE VILLAGE OVERLOOK
SYLVA NC
28779-2616
US

V. Phone/Fax

Practice location:
  • Phone: 828-586-7474
  • Fax: 828-586-7473
Mailing address:
  • Phone: 828-586-7474
  • Fax: 828-586-7473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number9400212
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number9400212
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: