Provider Demographics
NPI:1831157759
Name:BUONANNO, ANTHONY ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ROBERT
Last Name:BUONANNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1524 ATWOOD AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-3228
Mailing Address - Country:US
Mailing Address - Phone:401-351-6200
Mailing Address - Fax:401-351-6201
Practice Address - Street 1:1524 ATWOOD AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3228
Practice Address - Country:US
Practice Address - Phone:401-351-6200
Practice Address - Fax:401-351-6201
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05345207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
050397249OtherMULTIPLANS
050397249OtherPEQUOT PLUS HEALTH PLANS
103714900OtherU.S. DEPT. OF LABOR-WC
RI000364OtherBLUECHIP OF RI
050397249OtherFIRSTHLTH/COVENTRY/HCVM
RI27239OtherNEIGHBORHOOD HEALTH PLANS
RI5354/050397249OtherWORKERS COMPENSATION PLAN
RIAB-01884Medicaid
050397249OtherUNITEDHEALTHCARE
0900138OtherUNITEDHEALTHCARE
RI2287OtherBC BS OF RI
3179262-0001OtherCIGNA
4392040OtherAETNA
CD1829OtherRAILROAD MEDICARE
R000315/050397249OtherTRICARE
0900138OtherUNITEDHEALTHCARE
RI2287OtherBC BS OF RI
050397249OtherUNITEDHEALTHCARE