Healthcare Provider Details

I. General information

NPI: 1376235507
Provider Name (Legal Business Name): MICAELA BUHRMASTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 JIMMY DOOLITTLE DR STE B
GREENVILLE SC
29607-2622
US

IV. Provider business mailing address

PO BOX 6448
GREENVILLE SC
29606-6448
US

V. Phone/Fax

Practice location:
  • Phone: 864-640-4970
  • Fax: 864-520-8813
Mailing address:
  • Phone: 864-640-4970
  • Fax: 864-520-8813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: