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NPI Code Detail

MEDICARE: DR. KRISTA K BUCKLEY D.O.

MEDICARE:  DR. KRISTA K BUCKLEY  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
1207N00000XDermatology PhysicianH0067007MD

General Provider Information

NPI Number : 1952379745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTA K BUCKLEY D.O.
Provider Business Mailing Address
First Line : 71 OLD MILL BOTTOM RD N
Second Line : STE 300
City : ANNAPOLIS
State : MD
Zip : 21409-5410
Country : US
Telephone Number : 410-268-3887
Fax Number :
Provider Business Practice Location Address
First Line : 71 OLD MILL BOTTOM RD N
Second Line : STE 300
City : ANNAPOLIS
State : MD
Zip : 21409-5410
Country : US
Telephone Number : 410-268-3887
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 03/25/2015

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Directions to “ DR. KRISTA K BUCKLEY D.O.” Practice Location

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