Provider Demographics
NPI:1225126816
Name:BUCHANAN, MICHAEL JOSEPH (TECHNICIAN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BARNWELL ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-7064
Mailing Address - Country:US
Mailing Address - Phone:843-308-9662
Mailing Address - Fax:843-308-0293
Practice Address - Street 1:1050 REGISTER ST
Practice Address - Street 2:COMMANDING OFICER USCGC GALLATIN
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29415
Practice Address - Country:US
Practice Address - Phone:843-308-9662
Practice Address - Fax:843-308-0293
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other