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NPI Code Detail

MEDICARE: DR. MICHAEL BULETTE MD

MEDICARE:  DR. MICHAEL  BULETTE  MD
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
1207P00000XEmergency Medicine PhysicianMD073461LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1930110562OTHERPARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2BU1330380OTHERPABLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336180538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL BULETTE MD
Provider Business Mailing Address
First Line : 1872 ST LUKES BLVD
Second Line :
City : EASTON
State : PA
Zip : 18045-5669
Country : US
Telephone Number : 484-503-1200
Fax Number :
Provider Business Practice Location Address
First Line : 1872 ST LUKES BLVD
Second Line :
City : EASTON
State : PA
Zip : 18045-5669
Country : US
Telephone Number : 484-503-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 10/08/2025

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Directions to “ DR. MICHAEL BULETTE MD” Practice Location

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