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General NPI Number Information
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NPI Number | 1922050756
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Entity Type | Individual
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Provider Name | MICHAEL F BUSCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 1199 PRINCE AVENUE
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City | ATHENS
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State | GA
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Zip | 30606-2797
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Country | US
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Telephone | 706-389-3075
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Fax | 706-389-3076
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Provider Business Mailing Address
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Address Line | P.O. BOX 7547
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City | ATHENS
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State | GA
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Zip | 30604-7547
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Country | US
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Telephone | 706-389-3075
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Fax | 706-389-3076
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 01063717A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 36-115023
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 080219
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License Number State | GA
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