Provider Demographics
NPI:1003234105
Name:BUSCH, MEGAN ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:BUSCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1225 E CENTERTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTERTON
Mailing Address - State:AR
Mailing Address - Zip Code:72719-1225
Mailing Address - Country:US
Mailing Address - Phone:479-795-1301
Mailing Address - Fax:479-792-5130
Practice Address - Street 1:1225 E CENTERTON BLVD
Practice Address - Street 2:
Practice Address - City:CENTERTON
Practice Address - State:AR
Practice Address - Zip Code:72719-1225
Practice Address - Country:US
Practice Address - Phone:479-795-1301
Practice Address - Fax:479-792-5130
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-9487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine