Individual
JORGE BUSTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2494 BERNVILLE ROAD, SUITE 205, READING, PA 19605-9469
(610) 378-2996
(610) 208-8812
Mailing address
2500 BERNVILLE ROAD, READING, PA 19605-9453
(610) 378-2000
(610) 378-2799
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
D0078545
MD
207X00000X
Orthopaedic Surgery Physician
Primary
MD421803
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019586400010
—
PA
01
—
580344
MEDICARE
PA
05
—
745419800
—
MD
Enumeration date
04/17/2006
Last updated
04/02/2024
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