Individual
DR. LISA A BUKOVAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-8000
Mailing address
777 LOWNDES HILL RD BLDG 1, GREENVILLE, SC 29607-2101
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
0102201718
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010142041
—
VA
05
—
010165521
—
VA
Enumeration date
10/04/2005
Last updated
01/15/2021
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