Individual
MATTHEW N BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.A.
Contact information
Practice address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
(704) 939-1100
(704) 939-1173
Mailing address
1305 S CANNON BLVD, KANNAPOLIS, NC 28083-6232
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2218
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107207
—
NC
Enumeration date
08/06/2006
Last updated
07/08/2007
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