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Individual
DR. JUSTIN REEVES BULAND
Active
Individual
DR. JUSTIN REEVES BULAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2017010897
MO
208000000X
Pediatrics Physician
OS015778
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
2017010897
MO
2080N0001X
Neonatal-Perinatal Medicine Physician
OS015778
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
06/25/2008
Last updated
03/25/2020
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