Individual
CHARLES TOMMY BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1350 RALEIGH RD, CHAPEL HILL, NC 27517-4412
(984) 974-4200
Mailing address
5221 PARAMOUNT PKWY STE 420, MORRISVILLE, NC 27560-5491
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200661
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200661
NP LICENSE CERTIFICATE
NC
Enumeration date
09/21/2006
Last updated
09/22/2023
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