Provider Demographics
NPI:1598028706
Name:BUDI, NISHA HAQUE (DO)
Entity Type:Individual
Prefix:
First Name:NISHA
Middle Name:HAQUE
Last Name:BUDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:NISHA
Other - Middle Name:
Other - Last Name:HAQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:446 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601
Practice Address - Country:US
Practice Address - Phone:740-779-8214
Practice Address - Fax:740-779-8295
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI72799207P00000X
OH34.012962207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine