Provider Demographics
NPI:1558174417
Name:TAMY B. BUCKEL, M.D., P.A.
Entity type:Organization
Organization Name:TAMY B. BUCKEL, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:BISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-778-0003
Mailing Address - Street 1:250 HAACKE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1193
Mailing Address - Country:US
Mailing Address - Phone:410-778-0003
Mailing Address - Fax:410-778-4450
Practice Address - Street 1:100 BRAMBLE ST STE A
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2471
Practice Address - Country:US
Practice Address - Phone:410-778-0003
Practice Address - Fax:410-778-4450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAMY B BUCKEL MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty