Busch, Trevor L

Busch, Trevor L is an individual health care provider with primary practice located at 1415 Saint Francis Ave , Shakopee MN 55379-3374. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Busch, Trevor L can be contacted via phone (952) 993-7750.

Contact Information

Primary practice address
1415 Saint Francis Ave Shakopee MN 55379-3374
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37957 Minnesota

Profile Details

NPI number 1043297021
LBN Legal business name Busch, Trevor L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Mar 1st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043297021 NPPES
Minnesota MEDICAID 459813000

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