Healthcare Provider Details

I. General information

NPI: 1679513527
Provider Name (Legal Business Name): GEORGE D BUSSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 KALAKA PL
KAILUA HI
96734-5802
US

IV. Provider business mailing address

PO BOX 8500
PINEHURST NC
28374-8500
US

V. Phone/Fax

Practice location:
  • Phone: 808-260-8853
  • Fax:
Mailing address:
  • Phone: 910-715-5413
  • Fax: 910-715-1926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084H0002X
TaxonomyHospice and Palliative Medicine (Psychiatry & Neurology) Physician
License NumberMD4115
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License NumberMD4115
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD4115
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: