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Individual

MS. TINA MARIE BUSBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1128 NW HARRIMAN ST, BEND, OR 97701-1947
(541) 383-3005
(541) 383-1883
Mailing address
600 SW COLUMBIA ST STE 6210, BEND, OR 97702-1099
(541) 383-3005
(541) 383-1883

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD23807
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500608182
OR
01
804845005
BLUE CROSS BLUE SHIELD
OR
Enumeration date
07/19/2006
Last updated
01/30/2023
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