Provider Demographics
NPI:1174815146
Name:BUSH, LEAH LINDA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:LEAH
Middle Name:LINDA ELIZABETH
Last Name:BUSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8451 CHESTNUT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:NEW KENT
Mailing Address - State:VA
Mailing Address - Zip Code:23124-2307
Mailing Address - Country:US
Mailing Address - Phone:757-831-8588
Mailing Address - Fax:
Practice Address - Street 1:8451 CHESTNUT HILLS RD
Practice Address - Street 2:
Practice Address - City:NEW KENT
Practice Address - State:VA
Practice Address - Zip Code:23124-2307
Practice Address - Country:US
Practice Address - Phone:757-831-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101038817207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology