Individual
DR. TREVOR L BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 SAINT FRANCIS AVE, SHAKOPEE, MN 55379-3374
(952) 993-7750
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37957
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
459813000
—
MN
Enumeration date
12/29/2005
Last updated
03/01/2012
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