Provider Demographics
NPI:1760487797
Name:BUONOCORE, CAMILLE M (MD)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:M
Last Name:BUONOCORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3445
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-3445
Mailing Address - Country:US
Mailing Address - Phone:412-937-8887
Mailing Address - Fax:412-937-9221
Practice Address - Street 1:2000 OXFORD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-942-2140
Practice Address - Fax:412-942-6027
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOMD044291E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA250391OtherUPMC
PA1003718OtherGATEWAY
PA1016962350002OtherMEDICAID GROUP NO
PA103537OtherPA MCR GROUP PTAN
PA4413728OtherAETNA
PA185577OtherUNISON
PA0734545OtherCIGNA
PA469022OtherBCBS
PA001400867Medicaid
PAP00357335OtherRR MEDICARE
PA103537OtherPA MCR GROUP PTAN
PA469022VN9Medicare PIN