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NPI Code Detail

MEDICARE: ANDRE BUFFINGTON

MEDICARE: ANDRE BUFFINGTON
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1700374113
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRE BUFFINGTON
Provider Business Mailing Address
First Line : 2831 PROSPECT AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2606
Country : US
Telephone Number : 216-579-1330
Fax Number : 216-771-5114
Provider Business Practice Location Address
First Line : 2831 PROSPECT AVE E
Second Line :
City : CLEVELAND
State : OH
Zip : 44115-2606
Country : US
Telephone Number : 216-579-1330
Fax Number : 216-771-5114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2018
Last Update Date : 05/01/2018

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Directions to “ ANDRE BUFFINGTON ” Practice Location

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