Basic Information
Provider Information
NPI: 1952336471
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUCHNER
FirstName: ANNA
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3400 CIVIC CENTER BLVD
Address2: PCAM 4 SOUTH
City: PHILADELPHIA
State: PA
PostalCode: 191045127
CountryCode: US
TelephoneNumber: 2153498222
FaxNumber:  
Practice Location
Address1: 3400 CIVIC CENTER BLVD
Address2: PCAM 4 SOUTH
City: PHILADELPHIA
State: PA
PostalCode: 191045127
CountryCode: US
TelephoneNumber: 2153498222
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/12/2006
LastUpdateDate: 02/04/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100XMD436791PAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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