Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 35043378 | OH |
NPI | 1023091501 |
---|---|
Provider Name | Calvert Raymond Busch |
First Address | Kettering, OH 45429-4926 |
Second Address | Kettering, OH 45429-4926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 09/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000039027 | ANTHEM (01) | OH |
0398181 | (05) | OH |
060053779 | RR MEDICARE (01) | OH |
2153717 | AETNA (01) | OH |
2501766 | UNITED HEALTHCARE (01) | OH |
C03678 | (02) | OH |