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Individual

BETH L BUCHANAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2451 INTELLIPLEX DR STE 260, SHELBYVILLE, IN 46176-8580
(317) 398-0121
(317) 398-0538
Mailing address
30 W RAMPART ST, STE 200, SHELBYVILLE, IN 46176-8846
(317) 398-0121
(317) 398-1851

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01032192A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000375176
ANTHEM
IN
05
100127960
IN
01
P01197276
RR MEDICARE PTAN
IN
Enumeration date
07/27/2006
Last updated
12/27/2021
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