Doctor Name: | CRAIG M BUSH |
NPI Number: | 1548314784 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 0101239187 |
Business Practice Address: | 1060 Gaffney Rd Ste 7440 Commander Usa Meddac Ak Mcuc Mmd Attn Credentials Ft Wainwright, AK - 997035001 |
Business Phone Number: | 9073535418 |
Business Fax Number: | 9073534847 |
Mailing Address: | 1060 Gaffney Rd Ste 7440, Commander Usa Meddac Ak Mcuc Mmd Attn Credentials FT WAINWRIGHT |
State: | AK |
Postal Code: | 997037440 |
Phone Number: | 9073535418 |
Fax Number: | 9073534847 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0101239187 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |