Provider Demographics
NPI:1013914464
Name:BUINEWICZ, BRIAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:R
Last Name:BUINEWICZ
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 1:3655 ROUTE 202
Mailing Address - Street 2:SUITE 225
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-6601
Mailing Address - Country:US
Mailing Address - Phone:215-230-4103
Mailing Address - Fax:215-230-4143
Practice Address - Street 1:3655 ROUTE 202 STE 225
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-6600
Practice Address - Country:US
Practice Address - Phone:215-230-4013
Practice Address - Fax:215-230-4143
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2019-11-06
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07478400208200000X
PAMD036919E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF27894Medicare UPIN
PA720596Medicare ID - Type Unspecified