Provider Demographics
NPI:1699025494
Name:BUZAN, ERIK-BRANDON CLEMENT (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIK-BRANDON
Middle Name:CLEMENT
Last Name:BUZAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8520 E SHEA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6677
Mailing Address - Country:US
Mailing Address - Phone:480-588-6924
Mailing Address - Fax:
Practice Address - Street 1:8520 E SHEA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6677
Practice Address - Country:US
Practice Address - Phone:480-588-6924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5148363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant