Provider Demographics
NPI:1568448058
Name:BUXMAN, RICHARD A (DO)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:BUXMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 DARROW RD
Mailing Address - Street 2:STE 106
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5021
Mailing Address - Country:US
Mailing Address - Phone:330-656-5911
Mailing Address - Fax:330-656-5901
Practice Address - Street 1:1044 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44501
Practice Address - Country:US
Practice Address - Phone:330-746-7211
Practice Address - Fax:330-480-3916
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003832B207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH700007019OtherRAILROAD MEDICARE
OH0782523Medicaid
OH001474673-0001OtherPENNSYLVANIA MEDICAID
OH001474673-0005OtherPENNSYLVANIA MEDICAID
OH001474673-0005OtherPENNSYLVANIA MEDICAID
OHBU0659781Medicare PIN
OHBU0659784Medicare PIN
OH001474673-0001OtherPENNSYLVANIA MEDICAID