Organization
ERNESTO BUENCAMINO MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNESTO E BUENCAMINO MD (OWNER)
(262) 658-1678
Entity
Organization
Contact information
Practice address
3734 7TH AVE, SUITE 11, KENOSHA, WI 53140-5525
(262) 658-1678
(262) 658-2730
Mailing address
3734 7TH AVE, SUITE 11, KENOSHA, WI 53140-5525
(262) 658-1678
(262) 658-2730
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20272
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31102200
—
WI
Enumeration date
12/18/2006
Last updated
08/22/2020
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