Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 35054021B | OH |
N | 2086S0105X | Surgery of the Hand | 14863 | WV |
N | 2086S0122X | Plastic and Reconstructive Surgery | 14863 | WV |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 35054021B | OH |
NPI | 1376538298 |
---|---|
Provider Name | Dr. Marjorie L Bush |
First Address | Wheeling, WV 26003-6392 |
Second Address | Wheeling, WV 26003-6392 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0113817000 | (05) | WV |
0649856 | (05) | OH |
14863 | HMO (01) | |
240001428 | RAILROAD MEDICARE (01) | OH |
240001433 | RAILROAD MEDICARE (01) | WV |
E87039 | (02) |