MEDICARE: DENNIS J BUONO DO INC

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	34008701	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902046782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENNIS J BUONO DO INC

Provider Business Mailing Address
First Line	:	2621 E HARBOR RD
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-2607
Country	:	US
Telephone Number	:	419-732-9975
Fax Number	:	419-732-6415

Provider Business Practice Location Address
First Line	:	2621 E HARBOR RD
Second Line	:
City	:	PORT CLINTON
State	:	OH
Zip	:	43452-2607
Country	:	US
Telephone Number	:	419-732-9975
Fax Number	:	419-732-6415

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DENNIS J BUONO
Credential	:
Telephone Number	:	419-732-9975

Provider Enumeration Date	:	03/06/2009
Last Update Date	:	03/06/2009

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Directions to “DENNIS J BUONO DO INC ” Practice Location

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