MEDICARE: BRENDA S BUIS D.O.

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	207Q00000X	Family Medicine Physician	35-003584	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	9338635	OTHER	OH	PARTNERS PHYSICIAN GROUP MEDICARE GROUP #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1083864144	OTHER	OH	PORTAGE HILLS TYPE 2 NPI #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1841239274	OTHER	OH	PARTNERS PHYSICIAN GROUP TYPE 2 NPI #

General Provider Information

NPI Number	:	1881698413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA S BUIS D.O.

Provider Business Mailing Address
First Line	:	754 S CLEVELAND AVE
Second Line	:
City	:	MOGADORE
State	:	OH
Zip	:	44260-2205
Country	:	US
Telephone Number	:	330-628-2686
Fax Number	:	330-628-0828

Provider Business Practice Location Address
First Line	:	754 S CLEVELAND AVE
Second Line	:
City	:	MOGADORE
State	:	OH
Zip	:	44260-2205
Country	:	US
Telephone Number	:	330-628-2686
Fax Number	:	330-628-0828

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	03/29/2013

Similar Medicare Providers

1871668699 — DENNIS C. MCCLUSKEY, M.D. & ASSOCIATES, INC.
Practice Location Address:

754 S CLEVELAND AVE
MOGADORE, OH
44260-2205

Practice Phone: 330-628-0677
Practice Fax: 330-628-9195

1548600463 — DR. ROBERT LOUIS DENNIS D.D.S.
Practice Location Address:

738 S CLEVELAND AVE
MOGADORE, OH
44260-2205

Practice Phone: 330-628-0066
Practice Fax:

1275370959 — JENNIFER LYNN WYROCK GRANO AGNP-C
Practice Location Address:

754 S CLEVELAND AVE STE 300
MOGADORE, OH
44260-2210

Practice Phone: 330-877-3008
Practice Fax:

1174470249 — MR. THOMAS N. KINTZ
Practice Location Address:

4060 HIGHLAND DR
MOGADORE, OH
44260-2113

Practice Phone: 330-612-7620
Practice Fax:

1417951039 — BRIAN R CAIN M.D.
Practice Location Address:

754 S CLEVELAND AVE STE 300
MOGADORE, OH
44260-2210

Practice Phone: 330-877-3008
Practice Fax: 330-877-3032

1184605289 — SCOTT R PHELPS OT
Practice Location Address:

35 N CLEVELAND AVE , ALLIED HEALTH REHAB CENTER
MOGADORE, OH
44260-1365

Practice Phone: 330-628-0736
Practice Fax: 330-628-0739

Directions to “ BRENDA S BUIS D.O.” Practice Location

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