Individual
MONIQUE LYNNE BUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
13750 S 176TH AVE, GOODYEAR, AZ 85338-7679
(623) 680-5717
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R71432
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080741
—
WI
Enumeration date
11/01/2009
Last updated
08/27/2024
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