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General NPI Number Information
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NPI Number | 1235665068
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Entity Type | Individual
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Provider Name | CHRISTOPHER BUSUITO DO
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Gender | Male
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 19000 ST. JOE'S PARKWAY STE 310
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City | LIVONIA
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State | MI
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Zip | 48152
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Country | US
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Telephone | 734-743-4540
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Fax | 734-743-4541
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DRIVE STE J2000
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City | ANN ARBOR
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State | MI
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Zip | 48105
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Country | US
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Telephone | 734-747-6766
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Fax | 734-222-3100
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101028138
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License Number State | MI
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