Individual
MR. MARC ALLEN BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 MICHIGAN ST. NW, SUITE A721, GRAND RAPIDS, MI 49503
(616) 974-4493
Mailing address
100 MICHIGAN STREET NW, SUITE A721, GRAND RAPIDS, MI 49503
(616) 974-4493
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001779
MI
Other
Enumeration date
10/17/2006
Last updated
01/08/2013
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