MEDICARE: DR. SHAAVHREE YVETTE BUCKMAN M.D., PH.D.

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	208000000X	Pediatrics Physician	D0059021	MD

General Provider Information

NPI Number	:	1295837912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAAVHREE YVETTE BUCKMAN M.D., PH.D.

Provider Business Mailing Address
First Line	:	2020 UNIVERSITY BLVD W
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4424
Country	:	US
Telephone Number	:	301-946-5963
Fax Number	:

Provider Business Practice Location Address
First Line	:	7676 NEW HAMPSHIRE AVE
Second Line	:	SUITE 220
City	:	TAKOMA PARK
State	:	MD
Zip	:	20912-7512
Country	:	US
Telephone Number	:	301-331-2972
Fax Number	:	301-431-0008

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	07/08/2007

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