Provider Demographics
NPI:1194145425
Name:BUCHANAN, EMILYNNE B (DO)
Entity type:Individual
Prefix:DR
First Name:EMILYNNE
Middle Name:B
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:EMILYNNE
Other - Middle Name:
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8110 MAPLE LAWN BLVD STE 235
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2694
Mailing Address - Country:US
Mailing Address - Phone:301-340-8339
Mailing Address - Fax:301-340-9027
Practice Address - Street 1:844 WASHINGTON RD STE 302
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6664
Practice Address - Country:US
Practice Address - Phone:410-848-6294
Practice Address - Fax:410-848-3009
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2769207V00000X
MDH0089971207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDHOO89971OtherLICENSE
MDFB7346934OtherDEA