Provider Demographics
NPI:1891853594
Name:BUSH, ANDREW PANCHENKO (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PANCHENKO
Last Name:BUSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 3247
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-3247
Mailing Address - Country:US
Mailing Address - Phone:919-774-1355
Mailing Address - Fax:919-775-1644
Practice Address - Street 1:1139 CARTHAGE STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330
Practice Address - Country:US
Practice Address - Phone:919-774-1355
Practice Address - Fax:919-774-3395
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9500524207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery