DR. IVAN JOSE BUSTILLO CHAMS (NPI# 1457501827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457501827 |
| Entity Type | Individual |
| Full Name | DR. IVAN JOSE BUSTILLO CHAMS |
| Credential | MD |
| Practice Address |
1000 South Columbia Road Grand Forks ND 58206-6002 |
| Mailing Address |
Po Box 6002 Grand Forks ND 58206-6002 |
| Practice Telephone | 7017805000 |
| Practice Fax Number | 2037895184 |
| Mailing Telephone | 7017805000 |
| Mailing Fax Number | 2037895184 |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2014-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
PT12924 | ND | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1000 SOUTH COLUMBIA ROAD |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58206-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366439994 | Darrell Eugene Zeller | Obstetrics & Gynecology | 1000 South Columbia Road, Grand Forks, ND 58206-6002 | 2005-09-29 |
| 1083163331 | Robert Luke Sorvig | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58206-6002 | 2016-09-28 |
| 1144618810 | Sarah Ann Gabert | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2015-01-05 |
| 1053709725 | Max Whitney Stork | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2015-01-05 |
| 1396133062 | Lisa Lehn Durick | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2015-01-05 |
| 1588052252 | Kevin Keith Kern | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2015-01-05 |
| 1205224979 | Brandon M Hallquist | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2015-01-05 |
| 1730587312 | Jesse Lee Lunde | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2014-12-12 |
| 1558769133 | Brooke Melicher Hanson | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2014-12-12 |
| 1275931859 | Michael Douglas Meier | Pharmacist | 1000 South Columbia Road, Grand Forks, ND 58201 | 2014-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619283298 | Brandi Jo Miller | Physical Therapist | 1000 S Columbia Rd, Grand Forks, ND 58206 | 2010-08-20 |
| 1659569200 | Janet Lee | Neurological Surgery | 1300 S Columbia Rd, Grand Forks, ND 58206 | 2007-10-09 |
| 1831389857 | Genevieve Marie Ziegler | Occupational Therapist | 1000 S Columbia Rd, Grand Forks, ND 58206 | 2007-07-26 |
| 1033493473 | Cheri Langei | Social Worker | 151 S. 4th St, Suite 201, Grand Forks, ND 58206-5196 | 2011-10-04 |
| 1255647657 | Todd James Galbreath | Pharmacist | 1200 So. Columbia Rd., Altru Retail Pharmacy, Grand Forks, ND 58206-6002 | 2010-08-23 |
| 1821236100 | Mariah Rose Dolan | Physical Therapist | 1000 South Columiba Rd, Grand Forks, ND 58206-6002 | 2009-01-26 |
| 1235334269 | Jordan James Wojnarski | Speech-Language Pathologist | 1300 Columbia Road S, Grand Forks, ND 58206-6002 | 2007-06-19 |
| 1669681425 | Sara Elizabeth Bjerke | Specialist/Technologist | 1300 S Columiba Rd, Grand Forks, ND 58206-6002 | 2007-05-21 |
| 1306065602 | Lindsey G Miskavige | Speech-Language Pathologist | 1200 South Columbia Road, Grand Forks, ND 58206-6002 | 2007-04-25 |
| 1396836193 | Bernard Jerome Hoggarth | Pediatrics | 1000 S Columbia Road, Grand Forks, ND 58206-6002 | 2006-09-27 |
| Find all providers in zip 58206 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427122266 | Anil Potti | Internal Medicine | 1451 44th Ave S Ste E, Grand Forks, ND 58201-3434 | 2006-11-20 |
| 1225120652 | Kevin G Panico | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2006-09-30 |
| 1134520745 | Karine Darbinyan | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201 | 2014-09-15 |
| 1093801359 | Daniel J Walsh | Internal Medicine | 960 S Columbia Rd, Grand Forks, ND 58201-4030 | 2006-10-05 |
| 1669563771 | Todor Nedeltchev Dentchev | Internal Medicine | 960 S Columbia Rd - Altru Cancer Center, Grand Forks, ND 58201 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245397041 | Billings Clinic | Internal Medicine | 1305 15th Avenue W, Williston, ND 58801 | 2007-01-02 |
| 1013938752 | Howard L Russell | Internal Medicine | 820 N 4th St, Fargo, ND 58122-0001 | 2006-07-21 |
| 1922025907 | Anu G Gaba | Internal Medicine | 820 4th St N, Fargo, ND 58122-0001 | 2006-07-16 |
| 1982917506 | Abdallah Abou Zahr | Internal Medicine | 820 4th St N, Fargo, ND 58102-4539 | 2010-07-24 |
| 1922236793 | Peter C Kurniali | Internal Medicine | 300 N 7th St, Bismarck, ND 58501-4439 | 2009-06-30 |
| 1154505360 | F E K Addo Md PC | Internal Medicine | 300 W Century Ave, Bismarck, ND 58503-1401 | 2007-12-24 |
| 1043426034 | Amit Panwalkar | Internal Medicine | 820 4th St N, Fargo, ND 58102-4539 | 2007-05-15 |
| 1457429680 | Edward J Wos | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-12-04 |
| 1417027988 | John T Reynolds | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-11-09 |
| 1093813743 | Baruti Serabe | Internal Medicine | 222 N 7th St, Bismarck, ND 58501-4436 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58206 |
Please comment or provide details below to improve the information on DR. IVAN JOSE BUSTILLO CHAMS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.