Provider Demographics
NPI:1134278385
Name:BUSHER, JANICE T (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:T
Last Name:BUSHER
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 1:2210 HEMBY LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3773
Mailing Address - Country:US
Mailing Address - Phone:252-830-1680
Mailing Address - Fax:252-830-0926
Practice Address - Street 1:2210 HEMBY LN
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3773
Practice Address - Country:US
Practice Address - Phone:252-830-1680
Practice Address - Fax:252-830-0926
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30607207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20442OtherBCBS
NC890169EMedicaid
NC20442OtherBCBS
NC205183CMedicare ID - Type Unspecified