Individual
GERALD R. BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14973 W BELL RD STE 100, SURPRISE, AZ 85374-3878
(623) 815-2900
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32553
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
856859
—
AZ
01
—
AZ0763540
BCBS
AZ
Enumeration date
10/13/2006
Last updated
11/19/2024
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