Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 0101259755 | VA |
NPI | 1073939070 |
---|---|
Provider Name | Gregory Michael Buchek |
First Address | Wright-Patterson Afb, OH 45433 |
Second Address | Wright-Patterson Afb, OH 45433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2014 |
Last Update Date | 27/08/2020 |