Individual
DR. MARK A BUONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2477
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01066054A
IN
207L00000X
Anesthesiology Physician
ME82105
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000597628
ANTHEM PROVIDER NUMBER
IN
05
—
200927220
—
IN
05
—
266892100
—
FL
01
—
5124638
AETNA
FL
01
—
58790
BSFL
FL
01
—
59168214
BSAL
FL
Enumeration date
01/04/2006
Last updated
02/01/2021
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