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General NPI Number Information
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NPI Number | 1770993990
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Entity Type | Individual
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Provider Name | ANDREW BUSSEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2014
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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
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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 |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A142303
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MDR-6659
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 19717
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License Number State | HI
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