Healthcare Provider Details
I. General information
NPI: 1487215885
Provider Name (Legal Business Name): MEDICAL SERVICES OF BUFFALO, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2019
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
224 E MAIN ST
SPRINGVILLE NY
14141-1443
US
IV. Provider business mailing address
6075 POPLAR AVENUE SUITE 401
MEMPHIS TN
38119
US
V. Phone/Fax
- Phone: 716-592-2871
- Fax: 901-795-6060
- Phone: 901-795-3600
- Fax: 901-795-6060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SANFORD
GLANTZ
Title or Position: OWNER
Credential: MD
Phone: 901-795-3600