Provider Demographics
NPI:1780732438
Name:BUSS, JAMES G B (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:G B
Last Name:BUSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10000 ZANE AVE N
Mailing Address - Street 2:FAIRVIEW BROOKLYN PARK CLINIC
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-1400
Mailing Address - Country:US
Mailing Address - Phone:763-572-5700
Mailing Address - Fax:763-569-6258
Practice Address - Street 1:10000 ZANE AVE N
Practice Address - Street 2:FAIRVIEW BROOKLYN PARK CLINIC
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-1400
Practice Address - Country:US
Practice Address - Phone:763-572-5700
Practice Address - Fax:763-569-6258
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2012-04-11
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Provider Licenses
StateLicense IDTaxonomies
MN28493207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN112090500Medicaid
MN160002705Medicare PIN
MN112090500Medicaid