MEDICARE: CHARLES M. BUHRMAN, JR., PSYD, LLC

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	103T00000X	Psychologist

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245292663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLES M. BUHRMAN, JR., PSYD, LLC

Provider Business Mailing Address
First Line	:	8549 MONTGOMERY ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-0001
Country	:	US
Telephone Number	:	513-984-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	8549 MONTGOMERY ROAD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-0001
Country	:	US
Telephone Number	:	513-984-2200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHARLES M. BUHRMAN
Credential	:	PSYD
Telephone Number	:	513-984-2200

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	02/29/2012

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