Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MT205926 | PA |
N | 208600000X | Surgeon | MT205926 | PA |
Y | 2086S0120X | Pediatric Surgery | 38258 | OK |
NPI | 1003234568 |
---|---|
Provider Name | Christie Buonpane |
First Address | Oklahoma City, OK 73104-5047 |
Second Address | Danville, PA 17822-9800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 22/06/2021 |