Individual
DR. MORIA NICHOLS BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
230 FOUNTAIN CT, SUITE 260, LEXINGTON, KY 40509-1895
(859) 264-0660
(859) 264-0662
Mailing address
230 FOUNTAIN CT, SUITE 260, LEXINGTON, KY 40509-1895
(859) 264-0660
(859) 264-0662
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30550
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000392673
ANTHEM
KY
05
—
64305501
—
KY
05
—
65944761
—
KY
Enumeration date
02/22/2006
Last updated
05/21/2008
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