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General NPI Number Information
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NPI Number | 1053316034
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Entity Type | Individual
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Provider Name | EDWARD STEPHEN BUESCHER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 855 W BRAMBLETON AVE
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City | NORFOLK
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State | VA
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Zip | 23510-1005
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Country | US
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Telephone | 757-668-6464
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Fax | 757-668-6476
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Provider Business Mailing Address
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Address Line | 3936 REGAL CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-3839
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Country | US
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Telephone | 757-463-6090
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 0101048487
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License Number State | VA
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