Provider Demographics
NPI:1497752331
Name:BUSSINGER, ERNEST K (MD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:K
Last Name:BUSSINGER
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 1:3911 AVENUE B
Mailing Address - Street 2:STE 3100
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4617
Mailing Address - Country:US
Mailing Address - Phone:308-635-3033
Mailing Address - Fax:308-635-3010
Practice Address - Street 1:3911 AVENUE B
Practice Address - Street 2:STE 3100
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4617
Practice Address - Country:US
Practice Address - Phone:308-635-3033
Practice Address - Fax:308-635-3010
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12467207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE04008OtherBCBS
B90779Medicare UPIN
271400Medicare ID - Type Unspecified