Provider Demographics
NPI:1497741920
Name:BUSBY, MERLE RUDY (MD)
Entity Type:Individual
Prefix:DR
First Name:MERLE
Middle Name:RUDY
Last Name:BUSBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RUDY
Other - Middle Name:
Other - Last Name:BUSBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:901 W HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2727
Mailing Address - Country:US
Mailing Address - Phone:704-633-1581
Mailing Address - Fax:704-633-7032
Practice Address - Street 1:901 W HENDERSON ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2727
Practice Address - Country:US
Practice Address - Phone:704-633-1581
Practice Address - Fax:704-633-7032
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16836208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20380OtherBLUE CROSS
NC8920380Medicaid
NC4603OtherPARTNERS
NC4603OtherPARTNERS
D20640Medicare UPIN