Individual
SARA BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MSC 10 5560, UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-5062
(505) 272-6503
Mailing address
MSC 10 5560, UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-5062
(505) 272-6503
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
50326
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032518
—
AZ
01
—
Z179042
MEDICARE
AZ
Enumeration date
03/22/2012
Last updated
09/25/2015
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