SHANE DAVID BUSH

PORTAGE, IN
NPI1316258874
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01071914A)
Enumeration Date2010-06-29
Last Update Date2015-06-02
Business Address
Dr. SHANE DAVID BUSH M.D.
3630 WILLOWCREEK RD
PORTAGE, IN 46368-5075
Phone number: 219-364-3700
Mailing Address
Dr. SHANE DAVID BUSH M.D.
3630 WILLOWCREEK RD
PORTAGE, IN 46368-5075
Phone number: 219-707-1185
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