| Doctor Name: | DR. PETER DONALD BUSSELBERG |
| NPI Number: | 1558567974 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MT189143 |
| Business Practice Address: | 5775 Wayzata Blvd. Suite 190 Saint Louis Park, MN - 554162627 |
| Business Phone Number: | 9525411840 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1450 Nw 6035, MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554856035 |
| Phone Number: | 9525428553 |
| Fax Number: | |
| NPI Enumeration Date: | 06/22/2007 |
| NPI Last Update Date: | 05/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | MT189143 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |