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General NPI Number Information
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NPI Number | 1487945945
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Entity Type | Individual
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Provider Name | JONATHAN AARON BUICE MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1000 BLYTHE BLVD
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City | CHARLOTTE
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State | NC
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Zip | 28203-5812
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Country | US
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Telephone | 704-381-6806
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Fax | 704-381-6841
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Provider Business Mailing Address
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Address Line | PO BOX 422002
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City | ATLANTA
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State | GA
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Zip | 30342-9002
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Country | US
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Telephone | 770-894-7002
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 78615
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 78615
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License Number State | GA
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