Individual
CHARLES AMOS BUSH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4003 KRESGE WAY STE 300, LOUISVILLE, KY 40207-4652
(502) 897-5139
(502) 896-6218
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
01087790A
IN
2086S0129X
Vascular Surgery Physician
Primary
56602
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2015
Last updated
03/01/2024
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