Healthcare Provider Details

I. General information

NPI: 1972550564
Provider Name (Legal Business Name): FAMILY MEDICINE ASSOCIATES OF BIRDSBORO, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N FURNACE ST SUITE 100
BIRDSBORO PA
19508-2057
US

IV. Provider business mailing address

321 N FURNACE ST SUITE 100
BIRDSBORO PA
19508-2057
US

V. Phone/Fax

Practice location:
  • Phone: 610-582-5300
  • Fax: 610-582-1464
Mailing address:
  • Phone: 610-582-5300
  • Fax: 610-582-1464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK A BUCZEWSKI
Title or Position: PRESIDENT
Credential: D.O.
Phone: 610-582-5300