Provider Demographics
NPI:1760876080
Name:BUCHAN, ANDREW (DO)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BUCHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:300 WEST 27TH STREET
Practice Address - Street 2:SOUTHEASTERN HEALTH
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28359
Practice Address - Country:US
Practice Address - Phone:910-272-1478
Practice Address - Fax:910-671-5392
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC208733207R00000X
SC51926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCD1865019OtherMEDICARE PIN
SC519264Medicaid
SCSCD1869068OtherMEDICARE PIN