Individual
BUSH KAVURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(252) 399-8040
(252) 399-8829
Mailing address
1705 TARBORO ST SW, WILSON, NC 27893-3428
(252) 399-8040
(252) 399-8829
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
97-01789
NC
2084P0800X
Psychiatry Physician
Primary
0101-242842
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891157U
—
NC
Enumeration date
03/22/2006
Last updated
08/12/2011
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