Individual
DR. KAREN M BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7901 S 12TH ST STE 100, PORTAGE, MI 49024-3831
(269) 372-3000
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301505730
MI
2086S0122X
Plastic and Reconstructive Surgery Physician
2009-01735
NC
2086S0122X
Plastic and Reconstructive Surgery Physician
2170261
NY
2086S0122X
Plastic and Reconstructive Surgery Physician
25MA06639100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02131235170
—
NY
01
—
155UH
BCBSNC
NC
05
—
5913510
—
NC
Enumeration date
04/25/2006
Last updated
02/02/2022
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