Provider Demographics
NPI:1730409475
Name:BUISSON, VALERIE FABIOLA (MD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:FABIOLA
Last Name:BUISSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:285 E STATE ST STE 670
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4360
Mailing Address - Country:US
Mailing Address - Phone:614-566-8270
Mailing Address - Fax:614-566-8073
Practice Address - Street 1:113 14TH ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5545
Practice Address - Country:US
Practice Address - Phone:201-656-8353
Practice Address - Fax:201-656-8116
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ99999207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine