Provider Demographics
NPI:1316076060
Name:BUSCHMAN, BRIAN OLIVER (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:OLIVER
Last Name:BUSCHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6
Mailing Address - Street 2:
Mailing Address - City:ALLENWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:17810-0006
Mailing Address - Country:US
Mailing Address - Phone:406-230-0944
Mailing Address - Fax:
Practice Address - Street 1:US 15 - 2 MILES NORTH OF ALLENWOOD
Practice Address - Street 2:
Practice Address - City:ALLENWOOD
Practice Address - State:PA
Practice Address - Zip Code:17810-0000
Practice Address - Country:US
Practice Address - Phone:570-547-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241123207Q00000X
MT11255207Q00000X
PAMD437358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00432705OtherMEDICARE RR
00098006OtherBCBS MT
MT1316076060Medicaid
011000710Medicare PIN
P00432705OtherMEDICARE RR