Basic Information
Provider Information
NPI: 1457309809
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUSS
FirstName: DANIEL
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2925 CHICAGO AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554071321
CountryCode: US
TelephoneNumber: 6122625000
FaxNumber:  
Practice Location
Address1: 8100 W 78TH ST
Address2: SUITE 225
City: EDINA
State: MN
PostalCode: 554392516
CountryCode: US
TelephoneNumber: 9529469777
FaxNumber: 9529469888
Other Information
ProviderEnumerationDate: 05/05/2006
LastUpdateDate: 03/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X33036MNY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
018573801MNDOLI WASHINGTONOTHER
2379801MNAMERICA'S PPOOTHER
0082401801MNPREFERRED ONEOTHER
30239740005MN MEDICAID
090101201MNMEDICAOTHER
20003349101MNRAILROAD MEDICAREOTHER
10728701MNPATIENT CHOICEOTHER
12887001MNUCAREOTHER
090101201MNSELECT CAREOTHER
60D45BU01MNBLUE CROSS/SHIELDOTHER
HP1300201MNHEALTHPARTNERSOTHER


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