Individual
STEPHEN MICHAEL BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
509 SOUTH BYP, KENNETT, MO 63857-3248
(573) 888-0555
(573) 888-0556
Mailing address
PO BOX 405454, ATLANTA, GA 30384-5454
(573) 888-0555
(573) 888-0556
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2000158294
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205015506
—
MO
Enumeration date
09/09/2005
Last updated
07/23/2014
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