Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 02005661A | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 036142207 | IL |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 1420 | NE |
NPI | 1063714459 |
---|---|
Provider Name | Mrs. Tovah Ann Buikema |
First Address | Urbana, IL 61801-2500 |
Second Address | Urbana, IL 61801-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2010 |
Last Update Date | 10/07/2019 |