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Individual

DR. CARL E. BUSSMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M,D.

Contact information

Practice address
11133 DUNN RD, DEPARTMENT OF EMS, SAINT LOUIS, MO 63136-6119
(314) 653-5663
(314) 653-4164
Mailing address
409 CONWAY VILLAGE DR, SAINT LOUIS, MO 63141-5803
(314) 878-3571
(314) 439-9593

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036117250
IL
207P00000X
Emergency Medicine Physician
R7913
MO
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
R7913
MO
2086S0127X
Trauma Surgery Physician
R7913
MO
2086S0129X
Vascular Surgery Physician
R7913
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201656410
IL
05
201656410
MO
Enumeration date
08/18/2005
Last updated
06/26/2008
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