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NPI Code Detail

MEDICARE: DR. MARK EDWARD BUFALINI DMD MD

MEDICARE:  DR. MARK EDWARD BUFALINI  DMD 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
11223S0112XOral and Maxillofacial Surgery (Dentist)2007-00364NC
2204E00000XOral & Maxillofacial Surgery (D.M.D.)2007-00364NC
3208600000XSurgery Physician2007-00364NC
41223S0112XOral and Maxillofacial Surgery (Dentist)DS035576PA

General Provider Information

NPI Number : 1659481554
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK EDWARD BUFALINI DMD MD
Provider Business Mailing Address
First Line : 1305 PHYSICIANS DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7352
Country : US
Telephone Number : 910-762-2618
Fax Number : 910-763-5173
Provider Business Practice Location Address
First Line : 1305 PHYSICIANS DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7352
Country : US
Telephone Number : 910-762-2618
Fax Number : 910-763-5173
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 05/09/2023

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