| NPI | 1225050818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DONALD BUSH Physician/President 207-783-1328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine Sports Medicine |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2011-10-07 |