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Individual

JOHNNY BUZHARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2669 KINARD ST, NEWBERRY, SC 29108-2911
(803) 405-7415
Mailing address
6064 HWY 395, NEWBERRY, SC 29108

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
12161
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121610
SC
Enumeration date
02/13/2007
Last updated
07/09/2007
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