Provider Demographics
NPI:1093761678
Name:GUSHUE, GEORGE F (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:F
Last Name:GUSHUE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 KUSER RD
Mailing Address - Street 2:SUITE B7
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3829
Mailing Address - Country:US
Mailing Address - Phone:609-581-1400
Mailing Address - Fax:609-585-5234
Practice Address - Street 1:1542 KUSER RD
Practice Address - Street 2:SUITE B7
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3829
Practice Address - Country:US
Practice Address - Phone:609-581-1400
Practice Address - Fax:609-585-5234
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03977400207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2315904Medicaid
NJC29864Medicare UPIN
NJ748368Medicare ID - Type Unspecified