Provider Demographics
NPI:1801987151
Name:BUSH, ERIC J (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:BUSH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:780 MAIN ST
Mailing Address - Street 2:STE 1
Mailing Address - City:GT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-2180
Mailing Address - Country:US
Mailing Address - Phone:413-528-2418
Mailing Address - Fax:413-528-2907
Practice Address - Street 1:780 MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:GT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-2180
Practice Address - Country:US
Practice Address - Phone:413-528-2418
Practice Address - Fax:413-528-2907
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-10-06
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Provider Licenses
StateLicense IDTaxonomies
MA79735207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000020987OtherBOSTON MEDICAL CENTER HEALTH NET
110228080OtherPALMETTO GBA RAILROAD MEDICARE
3310803OtherCIGNA
0113741OtherGROUP HEALTH INCORPORATED
MA3149625OtherMEDICAID
CT079735OtherCONNECTICARE
NY11982OtherMVP HEALTH PLAN
NY10025271OtherCAPITAL DISTRICT PHYSICIANS HEALTH PLAN
MA3149625Medicaid
MA68690OtherHARVARD PILGRIM HEALTH CARE
MABUJ16521OtherBLUE CROSS BLUE SHIELD
MA079735OtherTUFTS HEALTH PLAN
0005007349OtherAETNA
MA23827OtherHEALTH NEW ENGLAND
MA079735OtherTUFTS HEALTH PLAN
NY11982OtherMVP HEALTH PLAN