Healthcare Provider Details

I. General information

NPI: 1609968734
Provider Name (Legal Business Name): ALBERT WALDEMAR BUCH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E STATE ROUTE 14 STE 201
COLUMBIANA OH
44408-8490
US

IV. Provider business mailing address

100 DEBARTOLO PL STE 200
YOUNGSTOWN OH
44512-6095
US

V. Phone/Fax

Practice location:
  • Phone: 234-287-6533
  • Fax: 330-932-2787
Mailing address:
  • Phone: 330-729-8146
  • Fax: 330-965-5229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.006382
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: