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Individual

GORDON A BUSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3501 SILVERSIDE ROAD, WILMINGTON, DE 19810-4910
(302) 479-3937
(302) 477-2650
Mailing address
3501 SILVERSIDE ROAD, WILMINGTON, DE 19810-4910
(302) 479-3937
(302) 477-2650

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C1-0000625
DE
207W00000X
Ophthalmology Physician
C10000625
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000055401
DE
01
180018339
MEDICARE RR
Enumeration date
05/17/2006
Last updated
04/19/2010
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