Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301096235 | MI |
N | 208600000X | Surgeon | 4301096235 | MI |
Y | 2086S0105X | Surgery of the Hand | 4301096235 | MI |
NPI | 1386959336 |
---|---|
Provider Name | Dr. Ara Nason Bush |
First Address | Warren, MI 48093-2546 |
Second Address | Shelby Township, MI 48315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2010 |
Last Update Date | 28/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4301096235 | MI LICENSE (01) | MI |