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Individual

SEAN P BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
464 CONGRESS AVE STE 260, NEW HAVEN, CT 06519-1362
(252) 917-9311
Mailing address
3657 MACGREGOR DOWNS RD, GREENVILLE, NC 27834-7409
(252) 917-9311

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A52112
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A521120
CA
Enumeration date
08/20/2006
Last updated
03/06/2021
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