Provider Demographics
NPI:1174572861
Name:BUKSTEIN, DON A (MD)
Entity type:Individual
Prefix:DR
First Name:DON
Middle Name:A
Last Name:BUKSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8585 W FOREST HOME AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53228
Mailing Address - Country:US
Mailing Address - Phone:414-529-8500
Mailing Address - Fax:414-529-8511
Practice Address - Street 1:2955 TRIVERTON PIKE DR.
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:844-692-7846
Practice Address - Fax:414-529-8511
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI24889-20207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI118OtherDEAN HEALTH INSURANCE
WI30473100Medicaid
WI003774150Medicare PIN
WI06302Medicare PIN
WI118OtherDEAN HEALTH INSURANCE
WI30473100Medicaid
WI030002120Medicare PIN
WI030513080Medicare PIN