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NPI Code Detail

MEDICARE: DAVID JOSEPH BUCZKOWSKE D.O.

MEDICARE: DAVID JOSEPH BUCZKOWSKE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianOS13441FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134489008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JOSEPH BUCZKOWSKE D.O.
Provider Business Mailing Address
First Line : PO BOX 741852
Second Line :
City : ATLANTA
State : GA
Zip : 30374-1852
Country : US
Telephone Number : 386-671-4519
Fax Number : 386-672-9904
Provider Business Practice Location Address
First Line : 701 W PLYMOUTH AVE
Second Line :
City : DELAND
State : FL
Zip : 32720-3236
Country : US
Telephone Number : 386-943-3086
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2012
Last Update Date : 01/15/2026

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