Provider Demographics
NPI:1952369449
Name:BUESCHER, PHILIP CLAY (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:CLAY
Last Name:BUESCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:501 FAIRMOUNT AVENUE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286
Mailing Address - Country:US
Mailing Address - Phone:410-494-7921
Mailing Address - Fax:410-902-8247
Practice Address - Street 1:515 FAIRMOUNT AVE STE 500
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5466
Practice Address - Country:US
Practice Address - Phone:410-494-1662
Practice Address - Fax:410-494-1718
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD29565207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD329271100Medicaid
MDK531149ROtherMEDICARE ID
MDK531149ROtherMEDICARE ID
MDB68696Medicare UPIN