Provider Demographics
NPI:1831154400
Name:BUSS, PAMELA A (DC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:BUSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7179 E 700 S
Mailing Address - Street 2:
Mailing Address - City:VELPEN
Mailing Address - State:IN
Mailing Address - Zip Code:47590
Mailing Address - Country:US
Mailing Address - Phone:812-630-6105
Mailing Address - Fax:
Practice Address - Street 1:509 E 6TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGBURG
Practice Address - State:IN
Practice Address - Zip Code:47542-1008
Practice Address - Country:US
Practice Address - Phone:812-683-2273
Practice Address - Fax:812-683-3191
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001880111N00000X
IN81000012A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
288110OtherBLUE CROSS
11305339OtherCAQH
147920Medicare ID - Type Unspecified
11305339OtherCAQH