Provider Demographics
NPI:1679558043
Name:BUSSENIERS, ANNE E (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:E
Last Name:BUSSENIERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 BURKE CENTRE PKWY
Mailing Address - Street 2:#390
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3750
Mailing Address - Country:US
Mailing Address - Phone:703-978-1196
Mailing Address - Fax:703-978-7762
Practice Address - Street 1:3 WASHINGTON CIR NW
Practice Address - Street 2:#303
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2356
Practice Address - Country:US
Practice Address - Phone:202-463-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMDI8044207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F37255Medicare UPIN