Provider Demographics
NPI:1326379231
Name:BUCHANAN, MARK CRAWFORD (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:CRAWFORD
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT OFFICE
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2212
Mailing Address - Country:US
Mailing Address - Phone:860-679-7503
Mailing Address - Fax:860-679-1610
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:OCCUPATIONAL MEDICINE
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-6210
Practice Address - Country:US
Practice Address - Phone:860-679-2893
Practice Address - Fax:860-679-4587
Is Sole Proprietor?:No
Enumeration Date:2010-01-18
Last Update Date:2022-09-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT037373207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine