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Individual

JOHN D. BUCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2733
(313) 916-9102
Mailing address
HENRY FORD HOSPITAL, 2799 W GRAND BLVD, DETROIT, MI 48202
(313) 916-2433
(313) 916-9102

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01038587A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01038587A
IN
207RP1001X
Pulmonary Disease Physician
01038587A
IN
207RP1001X
Pulmonary Disease Physician
Primary
4301070640
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100119740
IN
Enumeration date
12/01/2006
Last updated
08/06/2020
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