Provider Demographics
NPI:1801121215
Name:BUCHANAN, RALPH WILLIAM SR (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:WILLIAM
Last Name:BUCHANAN
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:515 MEALING RD
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8959
Mailing Address - Country:US
Mailing Address - Phone:706-495-6815
Mailing Address - Fax:803-279-4708
Practice Address - Street 1:44 OCEAN ST
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-2419
Practice Address - Country:US
Practice Address - Phone:706-495-6815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-03
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16884207Q00000X
FLME46383207Q00000X
SC7325207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine