Provider Demographics
NPI:1093477283
Name:BUDUGURE, BIZIMANA
Entity Type:Individual
Prefix:
First Name:BIZIMANA
Middle Name:
Last Name:BUDUGURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2354 SAN RAE DR APT H
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2779
Mailing Address - Country:US
Mailing Address - Phone:513-432-7003
Mailing Address - Fax:
Practice Address - Street 1:2354 SAN RAE DR APT H
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45419-2779
Practice Address - Country:US
Practice Address - Phone:513-432-7003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No376J00000XNursing Service Related ProvidersHomemaker