Healthcare Provider Details
I. General information
NPI: 1891764502
Provider Name (Legal Business Name): JOSEPH BUSCEMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/15/2006
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
603 N WILMOT RD STE 151
TUCSON AZ
85711-2701
US
IV. Provider business mailing address
PO BOX 910221
DALLAS TX
75391-0221
US
V. Phone/Fax
- Phone: 520-886-0206
- Fax: 520-886-0829
- Phone: 520-519-7700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 30682 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: