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Individual

DR. IAN WILSON BUSHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MHS-CL

Contact information

Practice address
1000 RESEARCH PARK BLVD, SUITE 200, CHARLOTTESVILLE, VA 22911-5842
(434) 951-2485
Mailing address
1000 RESEARCH PARK BLVD, SUITE 200, CHARLOTTESVILLE, VA 22911-5842
(434) 951-2485

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101234098
VA

Other

Enumeration date
07/03/2007
Last updated
07/08/2007
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