Provider Demographics
NPI:1962495622
Name:BUCHANAN, PHILIP D (PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:D
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6510
Mailing Address - Country:US
Mailing Address - Phone:919-942-0021
Mailing Address - Fax:919-967-9519
Practice Address - Street 1:201 SAGE RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6510
Practice Address - Country:US
Practice Address - Phone:919-942-0021
Practice Address - Fax:919-967-9519
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCABMG 1065170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics