Healthcare Provider Details

I. General information

NPI: 1861582512
Provider Name (Legal Business Name): ANTHONY JAMES BUSTI M.D., PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 03/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 E MONUMENT ST # 6-100
BALTIMORE MD
21287-0020
US

IV. Provider business mailing address

PO BOX 690044
SAN ANTONIO TX
78269-0044
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3380
  • Fax: 410-502-5146
Mailing address:
  • Phone: 469-337-9156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number40017
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ7659
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: