Provider Demographics
NPI:1811526379
Name:BUKOSKI, RONALD SCOTT (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:SCOTT
Last Name:BUKOSKI
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 1:7813 SHRADER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4210
Mailing Address - Country:US
Mailing Address - Phone:804-264-4545
Mailing Address - Fax:804-264-4260
Practice Address - Street 1:7813 SHRADER RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4210
Practice Address - Country:US
Practice Address - Phone:804-264-4545
Practice Address - Fax:804-264-4260
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101281638207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology