Provider Demographics
NPI:1295837912
Name:BUCKMAN, SHAAVHREE YVETTE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SHAAVHREE
Middle Name:YVETTE
Last Name:BUCKMAN
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4424
Mailing Address - Country:US
Mailing Address - Phone:301-946-5963
Mailing Address - Fax:
Practice Address - Street 1:7676 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7512
Practice Address - Country:US
Practice Address - Phone:301-331-2972
Practice Address - Fax:301-431-0008
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059021208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics