Provider Demographics
NPI:1336186378
Name:BUSH, ASHLEY I (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:I
Last Name:BUSH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:91 SUMMER ST
Mailing Address - Street 2:APARTMENT #3
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-2737
Mailing Address - Country:US
Mailing Address - Phone:617-726-8244
Mailing Address - Fax:
Practice Address - Street 1:13TH STREET, BUILDING 149
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129
Practice Address - Country:US
Practice Address - Phone:617-726-8244
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA817412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry