Individual
BENNY BUSLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1004 PARKWAY AVE, SUITE B, ELKHART, IN 46516-9348
(219) 309-8149
Mailing address
1004 PARKWAY AVE, SUITE B, ELKHART, IN 46516-9348
(219) 309-8149
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01033352
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100209290
—
IN
Enumeration date
06/22/2006
Last updated
08/27/2015
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