Provider Demographics
NPI:1588129050
Name:BUYCKS, MICHAEL (BS CRIMINAL JUSTICE)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BUYCKS
Suffix:
Gender:M
Credentials:BS CRIMINAL JUSTICE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4531 READING RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-1229
Mailing Address - Country:US
Mailing Address - Phone:513-679-4585
Mailing Address - Fax:513-482-6922
Practice Address - Street 1:4531 READING RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-1229
Practice Address - Country:US
Practice Address - Phone:513-679-4585
Practice Address - Fax:513-482-6922
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator