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Contact Information

KEVIN W BUSDIECKER, AA
2500 METRO HEALTH DRIVE
CLEVELAND, OH44109
 Phone: 216-778-5790
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiologist Assistant

367H00000X 32 Anesthesiology Assistant
Indicates primary specialty

NPI Profile & details for KEVIN W BUSDIECKER · (Male)

NPI # 1528073004
Status Active
Credentials AA
Entity Individual
Enumeration date 07/31/2006
Last updated 09/21/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 67-000036
  • OH Medicaid 2739264
  • OH Other 9724074 AETNA
  • OH Other 000000515962 ANTHEM
  • OH Other 0583328 BCMH
  • OH Other 430037559 RAILROAD MEDICARE
  • OH Other 000000232158 UNISON
  • OH Other 414955 WELLCARE MEDICAID
Hospital affiliation(s)
  • ST VINCENT CHARITY MEDICAL CENTER - (Acute Care)
    2351 EAST 22ND STREET
    CLEVELAND, OH 44115
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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