Katherine Marie Bussone PA-C

NPI 1780995902 - Physician Assistant - 363A00000X

NPI Details
NPI 1780995902
Gender Female
Enumeration Date 06/23/2010
Last Updated 11/19/2015
Entity Type Individual
Active Over 6 years ago
Practice Location
3185 MACATAWA DR SW
SUITE A
GRANDVILLE MI, 49418-3184, US
Phone (616) 391-4500
Fax (616) 486-0130
Business Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS MI, 49503-2560, US
Phone (616) 486-6790
Fax (616) 866-5386
Toxanomy
Taxonomy Code 363A00000X
License State Michigan
License Number 5601005777
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According to our database, Katherine Marie Bussone PA-C NPI is 1780995902, taxonomy code is 363A00000X and license number is 5601005777, license state is located at Michigan. Katherine Marie Bussone PA-C physically located at 3185 Macatawa Dr Sw, Grandville MI, 49418-3184. NPI Number Katherine Marie Bussone PA-C has the Individual type.

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1780995902 NPI number is provided on an as is basis without warranty of any kind. 1780995902 is maintained by the National Plan & Provider Enumeration System. The contents of Katherine Marie Bussone PA-C are for informational purposes only.