1992612592 NPI number — MISS ABIGAIL GRACE BUCHANAN OTD

Table of content: MISS ABIGAIL GRACE BUCHANAN OTD (NPI 1992612592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992612592 NPI number — MISS ABIGAIL GRACE BUCHANAN OTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUCHANAN
Provider First Name:
ABIGAIL
Provider Middle Name:
GRACE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
OTD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BUCHANAN
Provider Other First Name:
ABBY GRACE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1992612592
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10720 COLUMBIA PIKE STE 501
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20901-4437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-502-3024
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10720 COLUMBIA PIKE STE 501
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20901-4437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-502-3024
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2026

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: 225X00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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