Provider Demographics
NPI:1770773509
Name:BUSSEWITZ, ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:BUSSEWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:855 A AVE NE
Mailing Address - Street 2:P O BOX 3080
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-3080
Mailing Address - Country:US
Mailing Address - Phone:319-368-5500
Mailing Address - Fax:319-368-5503
Practice Address - Street 1:855 A AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5050
Practice Address - Country:US
Practice Address - Phone:319-368-5500
Practice Address - Fax:319-368-5503
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA39528207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology