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Individual

DR. BRADLEY BUSACCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7495 STATE RD, STE 325, CINCINNATI, OH 45255-6404
(513) 233-2000
(513) 624-2684
Mailing address
2060 READING RD, SUITE 150, CINCINNATI, OH 45202-1454
(513) 721-3200
(513) 639-3186

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
35048242B
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000020974
ANTHEM
OH
05
0511655
OH
01
0720620
UNITED HEALTHCARE
OH
01
1023323
AETNA
OH
01
287923
AMERIGROUP
OH
01
31157505103
CARESOURCE
OH
Enumeration date
05/31/2005
Last updated
07/29/2015
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