Healthcare Provider Details

I. General information

NPI: 1316865611
Provider Name (Legal Business Name): MARIA BUESKING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 FAIRPARK DR
BEREA OH
44017-2402
US

IV. Provider business mailing address

165 FAIRPARK DR
BEREA OH
44017-2402
US

V. Phone/Fax

Practice location:
  • Phone: 440-376-2351
  • Fax:
Mailing address:
  • Phone: 440-376-2351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: