MEDICARE: CHRISTOPHER BRYAN BUSH NP-C

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
1	363L00000X	Nurse Practitioner	RN204646	GA

General Provider Information

NPI Number	:	1538523964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER BRYAN BUSH NP-C

Provider Business Mailing Address
First Line	:	3237 SATELLITE BLVD STE 425
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-9009
Country	:	US
Telephone Number	:	678-257-2547
Fax Number	:	404-795-5832

Provider Business Practice Location Address
First Line	:	1720 PHOENIX BLVD STE 600
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-5596
Country	:	US
Telephone Number	:	678-257-2547
Fax Number	:	404-795-5832

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2016
Last Update Date	:	12/05/2023

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