Provider Demographics
NPI:1598862799
Name:BUCKENMAIER, CHESTER CHURCH III (MD)
Entity Type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:CHURCH
Last Name:BUCKENMAIER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2420 POWDERHORN WAY
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-1672
Mailing Address - Country:US
Mailing Address - Phone:410-721-1892
Mailing Address - Fax:410-782-5066
Practice Address - Street 1:WALTER REED ARMY MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-2949
Practice Address - Fax:202-782-5066
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC9300661207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology