Provider Demographics
NPI:1730252636
Name:BUCHER, MARY DODGE (NP C)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:DODGE
Last Name:BUCHER
Suffix:
Gender:F
Credentials:NP C
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:DELLE
Other - Last Name:DODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 UNIVERSITY WAY
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-4932
Mailing Address - Country:US
Mailing Address - Phone:864-503-5197
Mailing Address - Fax:864-503-5099
Practice Address - Street 1:800 UNIVERSITY WAY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4932
Practice Address - Country:US
Practice Address - Phone:864-503-5197
Practice Address - Fax:864-503-5099
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0067973363LF0000X
SC20443363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily