| Luis E Bustos M.d.,p.c. | |
|
29135 Ryan Rd Suite B Warren MI 48092-4276 | |
| (586) 558-5666 | |
| (586) 558-9333 |
| Full Name | Luis E Bustos M.d.,p.c. |
|---|---|
| Speciality | Clinic/center |
| Location | 29135 Ryan Rd, Warren, Michigan |
| Authorized Official Name and Position | Luis E Bustos (PRESIDENT) |
| Authorized Official Contact | 5865585666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis E Bustos M.d.,p.c. 29135 Ryan Rd Suite B Warren MI 48092-4276 Ph: (586) 558-5666 | Luis E Bustos M.d.,p.c. 29135 Ryan Rd Suite B Warren MI 48092-4276 Ph: (586) 558-5666 |
| NPI Number | 1730359514 |
|---|---|
| Provider Enumeration Date | 03/07/2008 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730359514 | NPI | - | NPPES |
| 101390582 | Medicaid | MI | |
| 0205006091 | Other | MI | BLUE CROSS BLUE SHIELD MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4301032972 (Michigan) | Primary |
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