Bush, Gwendolyn D
Bush, Gwendolyn D is an sole proprietor health care provider with primary practice located at 23195 Riverside Dr , Southfield MI 48033-7301. She recently has only one registered license in Ambulatory Health Care Facilities / Adult Day Care, which is considered as her primary health care specialty. Bush, Gwendolyn D can be contacted via phone (954) 806-9411.Contact Information
Primary practice address
23195 Riverside Dr
Southfield MI 48033-7301
Phone: (954) 806-9411
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Adult Day Care | 261QA0600X |
Profile Details
| NPI number | 1518548601 |
|---|---|
| LBN Legal business name | Bush, Gwendolyn D |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2021 |
| Last updated | Apr 20th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518548601 | NPPES |
| Michigan | MEDICAID | 9521503 |
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