Provider Demographics
NPI:1679546485
Name:VANBUSKIRK, CATHLEEN SUSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:SUSAN
Last Name:VANBUSKIRK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4745 ARAPAHOE AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1080
Mailing Address - Country:US
Mailing Address - Phone:303-546-6600
Mailing Address - Fax:303-546-6500
Practice Address - Street 1:4745 ARAPAHOE AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1080
Practice Address - Country:US
Practice Address - Phone:303-546-6600
Practice Address - Fax:303-546-6500
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2015-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO36624207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841499597OtherTAX ID#
COC496918OtherMEDICARE PTAN NUMBER
COG60701Medicare UPIN