Provider Demographics
NPI:1841507886
Name:BUCK, DAVID CARMINE JR (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARMINE
Last Name:BUCK
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:316 MANATEE AVENUE WEST
Mailing Address - Street 2:ATT: IPM CREDENTIALING
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8805
Mailing Address - Country:US
Mailing Address - Phone:941-748-2277
Mailing Address - Fax:941-748-8714
Practice Address - Street 1:316 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8805
Practice Address - Country:US
Practice Address - Phone:941-748-2277
Practice Address - Fax:941-748-1958
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09354800207R00000X
FLOS14184207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021222200Medicaid