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General NPI Number Information
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NPI Number | 1184110066
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Entity Type | Organization
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Legal Business Name | ANDREW D BUSSEY M.D. L.L.C.
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Dates
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Enumeration Date | 07/03/2018
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 1301 PUNCHBOWL ST
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City | HONOLULU
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State | HI
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Zip | 96813-2402
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Country | US
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Telephone | 808-266-0239
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 61507
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City | HONOLULU
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State | HI
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Zip | 96839-1507
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Country | US
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Telephone | 808-266-0239
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | ANDREW DAVIS BUSSEY
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Credential | MD
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Telephone | 808-266-0239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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