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Individual

MRS. CHARLENE C BUI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
7111 E 21ST STREET N, SUITE A, WICHITA, KS 67206
(316) 684-2851
(316) 686-7338
Mailing address
7111 E 21ST STREET N, SUITE A, WICHITA, KS 67206
(316) 684-2851
(316) 686-7338

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15-00989
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100416440A
KS
01
110718
BCBS GROUP
KS
05
200267110A
KS
01
426765
BCBS INDIVIDUAL
KS
01
481252306
TRICARE WPS
KS
05
482630
KS
Enumeration date
06/28/2006
Last updated
10/17/2012
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