Individual
LEO B BUSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3841 PIPER STREET, SUITE T100, ANCHORAGE, AK 99508
(907) 561-3211
(907) 562-7547
Mailing address
4951 BUSINESS PARK BLVD, ANCHORAGE, AK 99503-7174
(907) 743-7366
(907) 743-7241
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1492
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060051655
RAILROAD MEDICARE
AK
05
—
MD1492
—
AK
Enumeration date
07/13/2006
Last updated
02/27/2017
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