Provider Demographics
NPI:1538868799
Name:BUSBEE, LEHMAN BERNARD I
Entity type:Individual
Prefix:MR
First Name:LEHMAN
Middle Name:BERNARD
Last Name:BUSBEE
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21015 CLARE AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-2411
Mailing Address - Country:US
Mailing Address - Phone:216-337-1423
Mailing Address - Fax:
Practice Address - Street 1:21015 CLARE AVE
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-2411
Practice Address - Country:US
Practice Address - Phone:216-337-1423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRP837178172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH71803507Medicaid