Provider Demographics
NPI:1598881260
Name:CHAD D. BUOHL, PC
Entity Type:Organization
Organization Name:CHAD D. BUOHL, PC
Other - Org Name:EAST BERLIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BUOHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:717-259-8813
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17316-1010
Mailing Address - Country:US
Mailing Address - Phone:717-259-8813
Mailing Address - Fax:717-259-0988
Practice Address - Street 1:337 W KING ST
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-9730
Practice Address - Country:US
Practice Address - Phone:717-259-8813
Practice Address - Fax:717-259-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007522L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50030447OtherGROUP KEYSTONE HMO
PA903165OtherHIGHMARK BLUE SHIELD
PA10923906OtherCAQH TRIAD HEALTH AMERICA
PA3478163OtherAETNA HMO
PA7373065OtherAETNA PPO
PA50030447OtherBLUE CROSS GROUP
PA7373065OtherAETNA PPO
PA10923906OtherCAQH TRIAD HEALTH AMERICA
PAU79558Medicare UPIN
PA036384SJ8Medicare PIN