Provider Demographics
NPI:1073562492
Name:BUDEV, MILLIN CHANDU (MD)
Entity Type:Individual
Prefix:
First Name:MILLIN
Middle Name:CHANDU
Last Name:BUDEV
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 1:137 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:LADSON
Mailing Address - State:SC
Mailing Address - Zip Code:29456-3552
Mailing Address - Country:US
Mailing Address - Phone:843-797-3676
Mailing Address - Fax:843-797-3677
Practice Address - Street 1:137 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-3552
Practice Address - Country:US
Practice Address - Phone:843-797-3676
Practice Address - Fax:843-797-3677
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21896207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC218963Medicaid
SCH84424Medicare UPIN