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General NPI Number Information
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NPI Number | 1356622799
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Entity Type | Individual
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Provider Name | MICHAEL RYAN BUSCH DO
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Gender | Male
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 103 OMNI DR STE B
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City | SENECA
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State | SC
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Zip | 29672-9448
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Country | US
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Telephone | 864-482-3285
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Fax |
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Provider Business Mailing Address
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Address Line | 317 ST FRANCIS DRIVE SUITE 330
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City | GREENVILLE
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State | SC
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Zip | 29601
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Country | US
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Telephone | 864-335-7555
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Fax | 833-459-0877
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 40689
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 40689
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2735
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License Number State | WV
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