David H Bush, OD
Individual provider Active NPI Optometrist · Burton, MI
NPI 1902017007 · NPPES record last updated Nov 2, 2007
Key facts
- NPI
- 1902017007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 4901002444 (MI)
- Practice address
- G3525 S Saginaw St
Burton, MI 48529-1260 - Phone
- (810) 232-6031
- Fax
- (810) 232-6041
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goodwill Optical Inc | Optometrist | Past | Accepting new patients |
| Goodwill Optical LLC | Optometrist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901002444 | MI | Yes |
Addresses
Primary practice location
G3525 S Saginaw St
Burton, MI 48529-1260
Mailing address
105 W Exchange St
Spring Lake, MI 49456-2024
Phone (616) 846-0620
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5191166 | Medicaid | MI | |
| 4901002444 | Other | MI | LICENSE |
Other providers in Burton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.