Provider Demographics
NPI:1043202948
Name:BULUSU, USHA KURUMETY (MD)
Entity Type:Individual
Prefix:DR
First Name:USHA
Middle Name:KURUMETY
Last Name:BULUSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2489 TRAUTNER DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9596
Mailing Address - Country:US
Mailing Address - Phone:989-791-2020
Mailing Address - Fax:989-791-2083
Practice Address - Street 1:2489 TRAUTNER DR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9596
Practice Address - Country:US
Practice Address - Phone:989-791-2020
Practice Address - Fax:989-791-2083
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2020-02-07
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
MI4301059424207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4508443 10Medicaid
MI5650800001Medicare NSC
MIP15550001Medicare ID - Type Unspecified