Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 18670 | AL |
NPI | 1053383380 |
---|---|
Provider Name | Bryan S. Buchanan |
First Address | Fpo, AE 09645 |
Second Address | Fpo, AE 09645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 20/04/2008 |