Individual
GREGORY WAYNE BOUSKA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4421
(256) 265-1000
(256) 539-9472
Mailing address
2006 FRANKLIN ST SE, STE 301, HUNTSVILLE, AL 35801-4551
(256) 539-9471
(256) 539-9472
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
00016858
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51524642
BCBS- HH MAIN
AL
01
—
51524644
HH EAST
AL
01
—
51524645
BCBS- MADISON
AL
01
—
P00197715
RR MEDICARE
GA
Enumeration date
01/12/2006
Last updated
07/09/2007
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