Individual
KATHY A BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 FODEN ROAD WEST, SUITE 100, SOUTH PORTLAND, ME 04106
(207) 523-3900
(207) 523-8593
Mailing address
100 GANNETT DRIVE, SUITE C, SOUTH PORTLAND, ME 04106
(207) 347-2947
(207) 874-2317
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
017218
ME
207N00000X
Dermatology Physician
2005-00586
NC
207NP0225X
Pediatric Dermatology Physician
2005-00586
NC
207NS0135X
Procedural Dermatology Physician
2005-00586
NC
Other
Enumeration date
02/20/2006
Last updated
03/06/2026
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