Individual
DR. JAMESON GEORGE BUSTON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13540 HULL STREET RD, SUITE 110, MIDLOTHIAN, VA 23112-2107
(804) 739-6142
(804) 739-8923
Mailing address
4121 COX RD, SUITE 110, GLEN ALLEN, VA 23060-3321
(804) 545-1920
(804) 545-1656
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101016369
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09633
GROUP PTAN
VA
Enumeration date
09/27/2007
Last updated
12/16/2009
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