Individual
DR. MICHAEL F BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1199 PRINCE AVENUE, ATHENS, GA 30606-2797
(706) 389-3075
(706) 389-3076
Mailing address
P.O. BOX 7547, ATHENS, GA 30604-7547
(706) 389-3075
(706) 389-3076
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01063717A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
080219
GA
2085R0202X
Diagnostic Radiology Physician
36-115023
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000526572
ANTHEM
IN
05
—
200882040
—
IN
01
—
P00414287
MEDICARE RR
IN
Enumeration date
05/17/2006
Last updated
08/06/2018
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