MEDICARE: DONALD T BUISMAN MD

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	207P00000X	Emergency Medicine Physician	431182	KS
2	207P00000X	Emergency Medicine Physician	2004030782	MO
3	207P00000X	Emergency Medicine Physician	54902	MN

General Provider Information

NPI Number	:	1770565533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD T BUISMAN MD

Provider Business Mailing Address
First Line	:	2829 UNIVERSITY AVE SE STE 730
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-3279
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 NW 26TH ST
Second Line	:
City	:	OWATONNA
State	:	MN
Zip	:	55060-5503
Country	:	US
Telephone Number	:	507-977-2100
Fax Number	:

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	10/03/2024

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