Provider Demographics
NPI:1811293046
Name:BUSHAN, YMS (MD)
Entity type:Individual
Prefix:DR
First Name:YMS
Middle Name:
Last Name:BUSHAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8350 GREENSBORO DR
Mailing Address - Street 2:SUITE 908
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3533
Mailing Address - Country:US
Mailing Address - Phone:941-744-6147
Mailing Address - Fax:703-790-1616
Practice Address - Street 1:8350 GREENSBORO DR
Practice Address - Street 2:SUITE 908
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3533
Practice Address - Country:US
Practice Address - Phone:941-744-6147
Practice Address - Fax:703-790-1616
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-06
Last Update Date:2011-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101-043674208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice