Provider Demographics
NPI:1851731921
Name:BUSBY, MICHAEL S (MED, LAT, ACT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:BUSBY
Suffix:
Gender:M
Credentials:MED, LAT, ACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2965 CAPE COD CIR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6548
Mailing Address - Country:US
Mailing Address - Phone:903-746-7182
Mailing Address - Fax:
Practice Address - Street 1:110 SANDPIPER CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4742
Practice Address - Country:US
Practice Address - Phone:903-746-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider