Provider Demographics
NPI:1275505851
Name:BUDD, CLARE
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:BUDD
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 1:6530 ROUTE 22
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6530 ROUTE 22
Practice Address - Street 2:SUITE 200
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2414
Practice Address - Country:US
Practice Address - Phone:724-468-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006131E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001218824Medicaid
PA624418PD9Medicare ID - Type Unspecified