Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME116789 | FL |
Y | 207VX0201X | Gynecologic Oncologist | 26934 | WV |
NPI | 1083875710 |
---|---|
Provider Name | Dr. Stephen Harold Bush II |
First Address | Charleston, WV 25304-2696 |
Second Address | Charleston, WV 25304-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2008 |
Last Update Date | 07/09/2016 |