MEDICARE: DR. DENNIS J. BUONO 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
1	207QA0505X	Adult Medicine Physician	34008701	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1144209156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS J. BUONO D.O.

Provider Business Mailing Address
First Line	:	2621 E HARBOR RD
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-2607
Country	:	US
Telephone Number	:	419-732-9975
Fax Number	:	419-732-6415

Provider Business Practice Location Address
First Line	:	2621 E HARBOR RD
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-2607
Country	:	US
Telephone Number	:	419-732-9975
Fax Number	:	419-732-6415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	03/07/2023

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