Provider Demographics
NPI:1649473836
Name:BUSBY, ERIC STEVEN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:STEVEN
Last Name:BUSBY
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EARLS CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02770-2025
Mailing Address - Country:US
Mailing Address - Phone:508-679-7685
Mailing Address - Fax:
Practice Address - Street 1:119 COGGESHALL ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746-2443
Practice Address - Country:US
Practice Address - Phone:508-990-1900
Practice Address - Fax:508-990-1929
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1486363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Not Answered363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical