Luis E Bustos M.D.,P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

4301032972 Issued in MI

Legal business name

LUIS E BUSTOS M.D.,P.C.

Practice address

29135 Ryan Rd
Suite B
Warren, MI 48092-4276

Phone

(586) 558-5666

Fax

(586) 558-9333

NPI assigned

Mar 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Luis E Bustos, M.D.

Title

President

Phone

(586) 558-5666

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1730359514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29135 RYAN RD",
            "address_2": "SUITE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924276",
            "telephone_number": "586-558-5666",
            "fax_number": "586-558-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29135 RYAN RD",
            "address_2": "SUITE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924276",
            "telephone_number": "586-558-5666",
            "fax_number": "586-558-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS E BUSTOS M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "BUSTOS",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-558-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "4301032972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "0205006091",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101390582",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexander R Lussier, MD
• Jennifer Lynn Lutostanski, LBSW
• Jared Lutsic, DO
• Luxottica Retail North America Inc

• Clinic/Center in Warren, MI
• Providers in Warren, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.