Healthcare Provider Details

I. General information

NPI: 1003867938
Provider Name (Legal Business Name): CHRISTOPHER WILLIAM BUSER LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N GREENE ST BT/101/MC
BALTIMORE MD
21201-1524
US

IV. Provider business mailing address

905 BUCKINGHAM DR
STEVENSVILLE MD
21666-2729
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7259
  • Fax: 410-605-7912
Mailing address:
  • Phone: 410-643-3772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12761
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: