Provider Demographics
NPI:1891369492
Name:BUCHOWSKI, COLLEEN F
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:F
Last Name:BUCHOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11745 ROSA PARKS BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1269
Mailing Address - Country:US
Mailing Address - Phone:313-883-2277
Mailing Address - Fax:
Practice Address - Street 1:11745 ROSA PARKS BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-1269
Practice Address - Country:US
Practice Address - Phone:313-883-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other