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Individual

DR. SCOTT MASON BUCKINGHAM

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1504 HARCREST DR, MIDLAND, MI 48640-4717
(989) 636-7580
(989) 636-7583
Mailing address
1504 HARCREST DR, MIDLAND, MI 48640-4717
(989) 636-7580
(989) 636-7583

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
003193
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005131
VSP
MI
01
0992990001
ADMINISTAR FEDERAL
MA
01
900E66505
BCBS OF MICHIGAN
MA
Enumeration date
06/20/2005
Last updated
07/08/2007
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