Provider Demographics
NPI:1083734651
Name:BUDNY, ADAM M (DPM)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:M
Last Name:BUDNY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4472
Mailing Address - Country:US
Mailing Address - Phone:814-942-1166
Mailing Address - Fax:814-942-6222
Practice Address - Street 1:3000 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4472
Practice Address - Country:US
Practice Address - Phone:814-942-1166
Practice Address - Fax:814-942-6222
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003420213ES0103X
PASC005969213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
715926OtherHEALTH AMER/HEALTH ASSUR
1977488OtherHIGHMARK
2847672OtherUNITEDHEALTHCARE
7504845OtherCIGNA
411959OtherUPMC
715926OtherHEALTH AMER/HEALTH ASSUR
1977488OtherHIGHMARK