Provider Demographics
NPI:1467579300
Name:BUSKO, CARLTON WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:WALTER
Last Name:BUSKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 GERMANY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ELLIOTTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17024-9027
Mailing Address - Country:US
Mailing Address - Phone:717-582-4060
Mailing Address - Fax:717-582-3584
Practice Address - Street 1:606 GERMANY RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELLIOTTSBURG
Practice Address - State:PA
Practice Address - Zip Code:17024-9027
Practice Address - Country:US
Practice Address - Phone:717-582-4060
Practice Address - Fax:717-582-3584
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023697E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC33470Medicare UPIN