Provider Demographics
NPI:1932148244
Name:BUSH, STEVEN BRIAN (MD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:BRIAN
Last Name:BUSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3406 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-8915
Mailing Address - Country:US
Mailing Address - Phone:615-636-9834
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N STE 1204
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1620
Practice Address - Country:US
Practice Address - Phone:615-312-0600
Practice Address - Fax:615-320-3259
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD246982085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509253OtherMEDICAID - MTI
TN1509253Medicaid
TN3894771Medicaid
TN4089758OtherBCBS
TN4200634OtherBCBS TN
TN4291457OtherBCBS - MTI
KY64923634OtherKY MEDICAID
TNP00178417OtherRAILROAD MEDICARE
TN3894770Medicaid
TN4089768OtherBCBS
TN4291457OtherBCBS - MTI
KY64923634OtherKY MEDICAID
TN3894771Medicaid
TN3894770Medicare PIN
TN4200634OtherBCBS TN