Individual
MARK BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 HURT PLAZA SE SUITE 1108, ATLANTA, GA 30303
(404) 790-0317
Mailing address
50 HURT PLAZA SE SUITE 1108, ATLANTA, GA 30303
(404) 790-0317
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
003228805A
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003228805A
—
GA
Enumeration date
01/14/2020
Last updated
05/02/2022
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