Healthcare Provider Details

I. General information

NPI: 1023383668
Provider Name (Legal Business Name): FRANCESCA MARIE BUSKULIC D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 S PUTNAM ST
WILLIAMSTON MI
48895
US

IV. Provider business mailing address

3955 PATIENT CARE DR STE A
LANSING MI
48911-4271
US

V. Phone/Fax

Practice location:
  • Phone: 517-655-3515
  • Fax: 517-655-3743
Mailing address:
  • Phone: 517-374-7600
  • Fax: 517-374-9042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101019833
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: