Provider Demographics
NPI:1588628945
Name:BUSCHBACHER, RALPH (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:
Last Name:BUSCHBACHER
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 1:5891 TALL TIMBER RUN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8613
Mailing Address - Country:US
Mailing Address - Phone:317-679-7806
Mailing Address - Fax:317-582-1669
Practice Address - Street 1:5891 TALL TIMBER RUN
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8613
Practice Address - Country:US
Practice Address - Phone:317-679-7806
Practice Address - Fax:317-582-1669
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040214208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200016540Medicaid
IN264220AMedicare PIN
IN200016540Medicaid