Individual
EDWARD BUENO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Mailing address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009390
PHYS PLUS PROV #
WI
05
—
31415700
—
WI
01
—
70
DEANCARE PROV #
WI
Enumeration date
01/12/2006
Last updated
07/09/2007
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