Provider Demographics
NPI:1093027096
Name:BUDDHU, CAMILLA DEVI (MD)
Entity Type:Individual
Prefix:
First Name:CAMILLA
Middle Name:DEVI
Last Name:BUDDHU
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 1:1801 SUNSET DRIVE
Mailing Address - Street 2:INTERNAL MEDICINE CLINIC
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-4197
Mailing Address - Fax:803-434-4160
Practice Address - Street 1:1801 SUNSET DRIVE
Practice Address - Street 2:INTERNAL MEDICINE CLINIC
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-4197
Practice Address - Fax:803-434-4160
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL32834207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine