Provider Demographics
NPI:1316945835
Name:BUSH, TODD E (MD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:E
Last Name:BUSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8675 COLLEGE BOULEVARD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210
Mailing Address - Country:US
Mailing Address - Phone:913-345-9400
Mailing Address - Fax:913-345-9408
Practice Address - Street 1:8675 COLLEGE BOULEVARD
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:913-345-9400
Practice Address - Fax:913-345-9408
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2014-01-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0426765208000000X
MO103783208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics