Individual
DR. STEPHEN THOMAS BUSHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1902 JUDITH LN, SUITE 110, BOISE, ID 83705-5209
(208) 658-0800
(208) 323-1894
Mailing address
1902 JUDITH LN, SUITE 110, BOISE, ID 83705-5209
(208) 658-0800
(208) 323-1894
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M-5492
ID
2084P0804X
Child & Adolescent Psychiatry Physician
M-5492
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003533000
—
ID
Enumeration date
09/13/2005
Last updated
02/13/2018
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