Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DS019761L | PA |
Y | 213EG0000X | General Practice | DS019761L | PA |
NPI | 1003952771 |
---|---|
Provider Name | Dr. John M Bush |
First Address | York, PA 17403-4594 |
Second Address | York, PA 17403-4594 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |