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DR. EVAN REECE BUXBAUM MD

>> Pediatrics >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1174633069

Individual Registrant:
DR. EVAN REECE BUXBAUM MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
3305 RENNER DR  FORTUNA, CA 95540-3119 US
Tel: 707-725-9355  Fax: --

Contact information for business:
PO BOX 458  ORCAS, WA 98280-0458 US
Tel: 360-298-2710  Fax: --

Registration Information:
NPI: 1174633069
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
WAMD60027949
Y208000000XAllopathic & Osteopathic Physicians
Pediatrics
HIMD15949
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
CAA116531
N208000000XAllopathic & Osteopathic Physicians
Pediatrics
AK5472

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
8522369WA05
MD3127AK05




HEALTH CARE JOBS CA - Page 1



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