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NPI Code Detail

MEDICARE: DR. EVERETT M BUSH MD

MEDICARE:  DR. EVERETT M BUSH  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician35034799BOH
2207RC0000XCardiovascular Disease Physician4301050060MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200454OTHERPARAMOUNT
34215426OTHERAETNA
4000000603770OTHERANTHEM

General Provider Information

NPI Number : 1073516829
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EVERETT M BUSH MD
Provider Business Mailing Address
First Line : 2940 N MCCORD RD
Second Line :
City : TOLEDO
State : OH
Zip : 43615-1753
Country : US
Telephone Number : 419-842-3094
Fax Number : 419-842-3048
Provider Business Practice Location Address
First Line : 2940 N MCCORD RD
Second Line :
City : TOLEDO
State : OH
Zip : 43615-1753
Country : US
Telephone Number : 419-842-3094
Fax Number : 419-842-3048
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 12/23/2009

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Directions to “ DR. EVERETT M BUSH MD” Practice Location

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