Individual
DR. DAVID EDWARD BOUSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1941 NEW GARDEN RD STE 216, GREENSBORO, NC 27410-2555
(336) 288-8857
(336) 288-8769
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34563
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010055306
RAILROAD MEDICARE
NC
01
—
0101250
UNITED HEALTHCARE
NC
01
—
17062
BLUE CROSS BLUE SHIELD
NC
01
—
4503048
AETNA
NC
01
—
46129
MEDCOST, LLC
NC
01
—
7279468
CIGNA
NC
05
—
7917062
—
NC
Enumeration date
06/16/2006
Last updated
02/06/2023
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