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General NPI Number Information
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NPI Number | 1609885698
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Entity Type | Individual
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Provider Name | ANNIE MARLENE RILEY-BUSSEY MD
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Gender | Female
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Dates
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Enumeration Date | 08/07/2006
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 2864 WOODRUFF STREET
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City | FORT LIBERTY
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State | NC
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Zip | 28307
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Country | US
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Telephone | 910-570-3113
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Fax | 910-396-7271
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Provider Business Mailing Address
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Address Line | 4372 FERNCREEK DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-2525
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Country | US
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Telephone | 910-570-3113
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Fax | 910-396-7271
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301070450
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2009-01358
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License Number State | NC
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