Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 368 | ND |
Y | 103T00000X | Psychologist | 368 | ND |
NPI | 1013005446 |
---|---|
Provider Name | Brett J Buican |
First Address | Minot, ND 58702-5010 |
Second Address | Minot, ND 58701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12911 | (05) | ND |
Q10673 | (02) |