Healthcare Provider Details

I. General information

NPI: 1699861831
Provider Name (Legal Business Name): KATHRYN SUE REINHARDT BUCSHON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN S REINHARDT

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12613 CHESDIN LANDING DR
CHESTERFIELD VA
23838-3231
US

IV. Provider business mailing address

PO BOX 3366
EVANSVILLE IN
47732-3366
US

V. Phone/Fax

Practice location:
  • Phone: 804-301-4830
  • Fax: 804-863-4626
Mailing address:
  • Phone: 812-450-2240
  • Fax: 812-450-2710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01049634A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: