Provider Demographics
NPI:1831695451
Name:BUCK, SEAN DONOVAN (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:DONOVAN
Last Name:BUCK
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 1:4602 E UNIVERSITY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-7423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4602 E UNIVERSITY DR STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-7423
Practice Address - Country:US
Practice Address - Phone:480-588-0348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0062867207Q00000X
OK45899207Q00000X
WAIMLC.MD.61552720207Q00000X
TXV0597207Q00000X
NV25577207Q00000X
OH35C.001517207Q00000X
AZ73665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine