Individual
BRENDA S BUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
754 S CLEVELAND AVE, MOGADORE, OH 44260-2205
(330) 628-2686
(330) 628-0828
Mailing address
754 S CLEVELAND AVE, MOGADORE, OH 44260-2205
(330) 628-2686
(330) 628-0828
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-003584
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0532034
—
OH
01
—
1083864144
PORTAGE HILLS TYPE 2 NPI #
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
06/10/2005
Last updated
03/29/2013
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