Provider Demographics
NPI:1912384090
Name:GARCIA BUENO, CARLOS ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:GARCIA BUENO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BARRIO SAN ANSELMO NO. 226
Mailing Address - Street 2:FRACC. LA PRIMAVERA
Mailing Address - City:CULIACAN
Mailing Address - State:SINALOA
Mailing Address - Zip Code:80199
Mailing Address - Country:MX
Mailing Address - Phone:667-744-0185
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ86311962080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology