Individual
DR. RONALD L BUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
921 BOSTON TPKE, BOLTON, CT 06043-7403
(860) 646-0649
(860) 649-9195
Mailing address
921 BOSTON TPKE, BOLTON, CT 06043-7403
(860) 646-0649
(860) 649-9195
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
022901
CT
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
022901
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001229012
—
CT
01
—
022901
LICENSE
CT
Enumeration date
03/14/2006
Last updated
07/26/2013
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