MEDICARE: NEVE MARIE BUSCH 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	0010-16609	NC

General Provider Information

NPI Number	:	1780398362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEVE MARIE BUSCH PA-C

Provider Business Mailing Address
First Line	:	400 E MOREHEAD ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-2610
Country	:	US
Telephone Number	:	704-355-0607
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E MOREHEAD ST
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28202-2610
Country	:	US
Telephone Number	:	704-355-0607
Fax Number	:	724-658-3717

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

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	06/17/2026

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