Provider Demographics
NPI:1467544148
Name:BUURMAN, RICHARD MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MATTHEW
Last Name:BUURMAN
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 1:1645 S MAIN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-2908
Mailing Address - Country:US
Mailing Address - Phone:931-484-7531
Mailing Address - Fax:931-456-9515
Practice Address - Street 1:1645 S MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-2908
Practice Address - Country:US
Practice Address - Phone:931-484-7531
Practice Address - Fax:931-456-9515
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY28587207Q00000X
TN48126207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY080167905OtherPALMETTO GBA RR MEDICARE
KY64285877Medicaid
KY000000188288OtherANTHEM BCBS
KY000000188288OtherANTHEM BCBS
D29059Medicare UPIN