Provider Demographics
NPI:1386247880
Name:BUFFUM, DANIEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:BUFFUM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GROVE ST STE B12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2630
Mailing Address - Country:US
Mailing Address - Phone:508-683-0260
Mailing Address - Fax:
Practice Address - Street 1:100 GROVE ST STE B12
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2630
Practice Address - Country:US
Practice Address - Phone:508-683-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH236820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist