| Doctor Name: | MR. MATTHEW BUSSARD |
| NPI Number: | 1811127624 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | EMT-PARAMEDIC |
| License Number: | 49-51970 |
| Business Practice Address: | 602 Ash St Beech Grove, IN - 461072032 |
| Business Phone Number: | 3173394505 |
| Business Fax Number: | 3177872802 |
| Mailing Address: | 602 Ash St, BEECH GROVE |
| State: | IN |
| Postal Code: | 461072032 |
| Phone Number: | 3173394505 |
| Fax Number: | 3177872802 |
| NPI Enumeration Date: | 07/15/2009 |
| NPI Last Update Date: | 07/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146L00000X |
| License Number: | 49-51970 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Paramedic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An EMT, Paramedic is an individual trained and certified to perform advanced life support (ALS) in medical emergencies based on individual state boards. |