Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 4301104835 | MI |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 4301104835 | MI |
NPI | 1073923579 |
---|---|
Provider Name | Christopher Bush |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2014 |
Last Update Date | 30/09/2020 |