Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 02005192A | IN |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 02005192A | IN |
NPI | 1356782056 |
---|---|
Provider Name | Dr. Dustin Allen Buchanan |
First Address | Muncie, IN 47303-3988 |
Second Address | Muncie, IN 47303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2013 |
Last Update Date | 05/02/2019 |