Individual
JUSTIN DANIEL DEBUSCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
327 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9006
(681) 342-1000
Mailing address
2673 DAVISSON RUN RD, STE 303, BRIDGEPORT, WV 26330
(800) 541-4009
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
85837
WV
Other
Enumeration date
10/30/2020
Last updated
10/30/2020
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