Individual
DR. STANLEY SETH BUSH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1508B HARDEMAN AVE, MACON, GA 31201-1416
(478) 741-7337
(478) 741-7371
Mailing address
1508B HARDEMAN AVE, MACON, GA 31201-1416
(478) 741-7337
(478) 741-7371
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
048846
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000872737A
—
GA
01
—
582566360
CIGNA HEALTHCARE
GA
Enumeration date
05/31/2006
Last updated
09/23/2014
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