Provider Demographics
NPI:1700864063
Name:BUCHAN, DAVID S (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:BUCHAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 W WILSON BRIDGE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2217
Mailing Address - Country:US
Mailing Address - Phone:614-895-8747
Mailing Address - Fax:614-895-3246
Practice Address - Street 1:350 W WILSON BRIDGE RD STE 200
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085
Practice Address - Country:US
Practice Address - Phone:614-895-8747
Practice Address - Fax:614-895-3246
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002217213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0657856Medicaid
OH0550162Medicare PIN
OHBU0550163Medicare PIN
OH0550163Medicare PIN
OH0550164Medicare PIN
OH0657856Medicaid
OHBU0550161Medicare PIN
OHT80773Medicare UPIN
OHBU0550164Medicare PIN
OHBU0550162Medicare PIN