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General NPI Number Information
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NPI Number | 1508820705
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Entity Type | Individual
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Provider Name | JOEL RUSSELL BUHYOFF CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 11848 ROCK LANDING DR
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4425
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Country | US
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Telephone | 757-596-2762
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Fax | 757-595-2001
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Provider Business Mailing Address
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Address Line | 7842 KILLDEE DR
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City | GLOUCESTER PT
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State | VA
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Zip | 23062-2122
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Country | US
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Telephone | 804-642-9320
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Fax | 804-642-9320
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024103780
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License Number State | VA
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