Provider Demographics
NPI:1437155900
Name:BUI, STEPHEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 STRICKLER AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:PA
Mailing Address - Zip Code:17268-1858
Mailing Address - Country:US
Mailing Address - Phone:717-559-0559
Mailing Address - Fax:717-387-5026
Practice Address - Street 1:11110 MEDICAL CAMPUS RD
Practice Address - Street 2:SUITE 205
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6700
Practice Address - Country:US
Practice Address - Phone:301-665-4950
Practice Address - Fax:240-500-1901
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005954213ES0103X, 213E00000X, 213E00000X
MD01517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6987970015Medicare NSC
PAU98848Medicare UPIN
PA6987970001Medicare NSC
PA120377XN1Medicare PIN