Individual
DR. STEPHEN HAROLD BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3302
(304) 388-1515
(304) 388-1570
Mailing address
830 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3302
(304) 388-1515
(304) 388-1570
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
13491
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722081
BLUE CROSS
WV
05
—
0091168000
—
WV
01
—
245048
MAMSI UNITED HEALTH CARE
WV
01
—
4245361
AETNA
WV
01
—
550691297
SELECT NET
WV
Enumeration date
02/08/2006
Last updated
04/06/2022
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