Individual
MARY E BUKOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1817 W MORRIS BLVD, MORRISTOWN, TN 37813-2837
(423) 581-3904
(423) 581-6120
Mailing address
1225 E WEISGARBER RD STE 200, KNOXVILLE, TN 37909-2675
(865) 584-4747
(865) 584-1363
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
6021
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3149630
—
TN
Enumeration date
10/04/2006
Last updated
11/08/2018
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