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Organization
BUSH MD PC
Active
Organization
BUSH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN MCDONALD (CREDENTIALING)
(219) 769-1670
Entity
Organization
Contact information
Practice address
3156 WILLOWCREEK RD, PORTAGE, IN 46368-4424
(219) 762-4999
Mailing address
55 E 86TH AVE, MERRILLVILLE, IN 46410-6382
(219) 769-1670
(219) 738-6714
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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