Provider Demographics
NPI:1568402501
Name:BUSCH, JULIE E (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:BUSCH
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1001 S KIRKWOOD RD
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-7254
Mailing Address - Country:US
Mailing Address - Phone:314-543-5943
Mailing Address - Fax:314-543-5953
Practice Address - Street 1:1001 S KIRKWOOD RD
Practice Address - Street 2:STE 300
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-7254
Practice Address - Country:US
Practice Address - Phone:314-543-5943
Practice Address - Fax:314-543-5953
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2017-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2004012259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine