Provider Demographics
NPI:1659661577
Name:BUCHKO, CHRISTY ANN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ANN
Last Name:BUCHKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:ANN
Other - Last Name:ESTEP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4605 MACCORKLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1311
Mailing Address - Country:US
Mailing Address - Phone:304-414-4800
Mailing Address - Fax:
Practice Address - Street 1:506 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309
Practice Address - Country:US
Practice Address - Phone:304-766-8558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810027604Medicaid
WVWV4410DMedicare PIN
WVWV4410EMedicare PIN
WVWV4410AMedicare PIN
WVWV4410BMedicare PIN
WVWV4410B279Medicare PIN
WV3810027604Medicaid