Provider Demographics
NPI:1710732201
Name:BUSH, DAVID III
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BUSH
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 FLESTER LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-6512
Mailing Address - Country:US
Mailing Address - Phone:202-774-7726
Mailing Address - Fax:
Practice Address - Street 1:7225 COTTESMORE LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-4703
Practice Address - Country:US
Practice Address - Phone:440-487-5670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)