Provider Demographics
NPI:1770876500
Name:BUECHEL, ADAM QUINCY (DO)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:QUINCY
Last Name:BUECHEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 AFRICA RD STE 220
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9808
Mailing Address - Country:US
Mailing Address - Phone:614-882-2349
Mailing Address - Fax:614-882-9005
Practice Address - Street 1:625 AFRICA RD STE 220
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082
Practice Address - Country:US
Practice Address - Phone:614-882-2349
Practice Address - Fax:614-882-9005
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.011240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0100695Medicaid
OH0100695Medicaid