Provider Demographics
NPI:1669412839
Name:BUSSARD, ANNE L (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:L
Last Name:BUSSARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:85 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:19087-2556
Practice Address - Country:US
Practice Address - Phone:610-688-3744
Practice Address - Fax:610-971-9562
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425829207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7609720OtherAETNA
PABU1743466OtherHIGHMARK BLUE SHIELD
PA2409269000OtherINDEPENDENCE BLUE CROSS
PA094212Medicare ID - Type Unspecified
PA7609720OtherAETNA