Healthcare Provider Details

I. General information

NPI: 1013250133
Provider Name (Legal Business Name): JONATHAN BUGGEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST STE 300
AKRON OH
44304-1473
US

IV. Provider business mailing address

95 ARCH ST STE 300
AKRON OH
44304-1473
US

V. Phone/Fax

Practice location:
  • Phone: 724-422-6808
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.128710
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: