Provider Demographics
NPI:1922134303
Name:BUCHNER, ANNMARIE LEMKE
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:LEMKE
Last Name:BUCHNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNMARIE
Other - Middle Name:
Other - Last Name:LEMKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5200 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3713
Mailing Address - Country:US
Mailing Address - Phone:989-793-6138
Mailing Address - Fax:989-793-5638
Practice Address - Street 1:5200 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3713
Practice Address - Country:US
Practice Address - Phone:989-793-6138
Practice Address - Fax:989-793-5638
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000031231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI01106161OtherASHA CERTIFICATION
MI640G312090OtherBLUE CROSS PIN
MI1601000031OtherMICHIGAN STATE LICENSE