Provider Demographics
NPI:1558634394
Name:BUENSALIDO, JOSEPH ADRIAN LUMAWIG (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH ADRIAN
Middle Name:LUMAWIG
Last Name:BUENSALIDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3990 JOHN R STREET
Mailing Address - Street 2:5 HUDSON, ROOM 5910
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-9649
Mailing Address - Fax:313-993-0302
Practice Address - Street 1:3990 JOHN R STREET
Practice Address - Street 2:5 HUDSON, ROOM 5910
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-9649
Practice Address - Fax:313-993-0302
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program