Individual
DR. RUSSELL LESLIE BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
1 GENESYS PKWY, GRAND BLANC, MI 48439-8065
(810) 606-7723
(810) 606-5991
Mailing address
720 4TH ST, LAPEER, MI 48446-1447
(810) 664-8523
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
4301405603
MI
Other
Enumeration date
04/27/2006
Last updated
12/05/2007
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