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Individual

DR. VICTOR WILLIAM BUSTARD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 CHELSEA RD, SUITE 2, TRENT WOODS, NC 28562-7149
(252) 633-3339
Mailing address
601 CHELSEA RD, SUITE 2, TRENT WOODS, NC 28562-7149
(252) 633-3339

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
21254
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20435
BCBS
NC
05
8920435
NC
Enumeration date
03/16/2006
Last updated
07/08/2007
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