MEDICARE: DR. SHAIL BUSBEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician		IL

General Provider Information

NPI Number	:	1225168040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAIL BUSBEY M.D.

Provider Business Mailing Address
First Line	:	20 PARK PL
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-2826
Country	:	US
Telephone Number	:	973-218-1191
Fax Number	:	973-218-1191

Provider Business Practice Location Address
First Line	:	20 PARK PL
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-2826
Country	:	US
Telephone Number	:	973-218-1101
Fax Number	:	973-218-1101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	08/23/2007

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