MEDICARE: BRANDI JONEE BUSKIRK PA-C

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	363A00000X	Physician Assistant	5601005850	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23-1806	OTHER	MI	MEDICARE PART A
3	0B56065	OTHER	MI	MEDICARE PART B

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1386624278	OTHER	MI	GROUP NPI

General Provider Information

NPI Number	:	1245530823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI JONEE BUSKIRK PA-C

Provider Business Mailing Address
First Line	:	225 E 5TH ST
Second Line	:	SUITE 300
City	:	FLINT
State	:	MI
Zip	:	48502-1641
Country	:	US
Telephone Number	:	810-406-4912
Fax Number	:	810-424-6029

Provider Business Practice Location Address
First Line	:	4001 N SAGINAW ST
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48505-3994
Country	:	US
Telephone Number	:	810-789-9141
Fax Number	:	810-789-9222

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

Provider Enumeration Date	:	10/28/2010
Last Update Date	:	01/08/2021

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Directions to “ BRANDI JONEE BUSKIRK PA-C” Practice Location

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