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General NPI Number Information
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NPI Number | 1952365652
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Entity Type | Individual
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Provider Name | ERIC JASON BUCHBAUM DPM
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Gender | Male
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Dates
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Enumeration Date | 04/12/2006
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 1 HIGH ST
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City | WAKEFIELD
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State | RI
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Zip | 02879-3103
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Country | US
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Telephone | 401-789-1422
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Fax | 401-782-6810
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Provider Business Mailing Address
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Address Line | 1 HIGH ST
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City | WAKEFIELD
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State | RI
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Zip | 02879-3103
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Country | US
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Telephone | 401-789-1422
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Fax | 401-782-6810
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | DPM00302
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License Number State | RI
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