Bustos, Alice C

Bustos, Alice C is an individual health care provider with primary practice located at 7220 W National Ave , West Allis WI 53214-4734. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Bustos, Alice C can be contacted via phone (414) 257-8500.

Contact Information

Primary practice address
7220 W National Ave West Allis WI 53214-4734
Fax: (414) 257-8505
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 34039-020 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34039-020 Wisconsin

Profile Details

NPI number 1861440505
LBN Legal business name Bustos, Alice C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Nov 29th, 2021 - about 4 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 1861440505 NPPES
Wisconsin MEDICAID 32058200

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