Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1147 | ME |
NPI | 1104801067 |
---|---|
Provider Name | Boyd R Buser |
First Address | Biddeford, ME 04005-9526 |
Second Address | Biddeford, ME 04005-9526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E11254 | (02) | ME |