Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 42370 | CO |
NPI | 1144299751 |
---|---|
Provider Name | Dr. Mark Robert Bush |
First Address | Littleton, CO 80129-1901 |
Second Address | Littleton, CO 80129-1901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G20288 | (02) |