1922134303 NPI number — ANNMARIE LEMKE BUCHNER

Table of content: ANNMARIE LEMKE BUCHNER (NPI 1922134303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922134303 NPI number — ANNMARIE LEMKE BUCHNER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUCHNER
Provider First Name:
ANNMARIE
Provider Middle Name:
LEMKE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEMKE
Provider Other First Name:
ANNMARIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922134303
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 STATE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48603-3713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-793-6138
Provider Business Mailing Address Fax Number:
989-793-5638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5200 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48603-3713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-793-6138
Provider Business Practice Location Address Fax Number:
989-793-5638
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  1601000031 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01106161 . This is a "ASHA CERTIFICATION" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 640G312090 . This is a "BLUE CROSS PIN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1601000031 . This is a "MICHIGAN STATE LICENSE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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