Individual
DR. JELANIE RAE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3537 W FRONT ST, SUITE G, TRAVERSE CITY, MI 49684-7941
(231) 935-8822
(231) 935-8837
Mailing address
3537 W FRONT ST, SUITE G, TRAVERSE CITY, MI 49684-7941
(231) 935-8822
(231) 935-8837
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301092782
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023271780
—
MI
01
—
1417961137
BCBSM - BRONSON
MI
Enumeration date
07/02/2008
Last updated
11/07/2016
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