Provider Demographics
NPI:1750387460
Name:BUSSIAN, ANNE HEARN (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:HEARN
Last Name:BUSSIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:LOUISE
Other - Last Name:HEARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3550 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5710
Mailing Address - Country:US
Mailing Address - Phone:205-949-2806
Mailing Address - Fax:205-949-2875
Practice Address - Street 1:3550 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5710
Practice Address - Country:US
Practice Address - Phone:205-949-2806
Practice Address - Fax:205-949-2875
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20116207ZD0900X
NC200300126207ZD0900X
FLME87844207ZD0900X
LA15720R207ZD0900X
GA056804207ZD0900X
TXM5081207ZD0900X
TN42017207ZD0900X
MDD0066829207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009945485Medicaid
AL009945485Medicaid
AL051518685Medicare ID - Type Unspecified