Provider Demographics
NPI:1386613925
Name:BUOHL, CHAD DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:DAVID
Last Name:BUOHL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:EAST BERLIN
Mailing Address - State:PA
Mailing Address - Zip Code:17316-1010
Mailing Address - Country:US
Mailing Address - Phone:717-259-8813
Mailing Address - Fax:717-259-0988
Practice Address - Street 1:337 W KING ST
Practice Address - Street 2:
Practice Address - City:EAST BERLIN
Practice Address - State:PA
Practice Address - Zip Code:17316-9730
Practice Address - Country:US
Practice Address - Phone:717-259-8813
Practice Address - Fax:717-259-0988
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007552L111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10923906OtherTRIAD
PA50030447OtherBLUE CROSS
PA3000240OtherHMO KEYSTONE
PA50030444OtherKEYSTONE BC HMO
PA903165OtherHIGHMARK BLUE SHIELD
PA3478163OtherAETNA
PA50030447OtherBLUE CROSS
PA903165OtherHIGHMARK BLUE SHIELD
PA10923906OtherTRIAD