Basic Information
Provider Information
NPI: 1427162650
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUESE
FirstName: FRANK
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5665 NEW NORTHSIDE DR NW
Address2: SUITE 320
City: ATLANTA
State: GA
PostalCode: 303285831
CountryCode: US
TelephoneNumber: 7708745400
FaxNumber: 7708745469
Practice Location
Address1: 3950 AUSTELL RD
Address2:  
City: AUSTELL
State: GA
PostalCode: 301061121
CountryCode: US
TelephoneNumber: 7707324000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/17/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X040625GAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

ID Information
IDTypeStateIssuerDescription
00465187F05GA MEDICAID
00465187G05GA MEDICAID
13793090001GADOLOTHER


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