Provider Demographics
NPI:1760412100
Name:BUDWAY, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BUDWAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-721-4280
Mailing Address - Fax:
Practice Address - Street 1:207 W FULTON ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1902
Practice Address - Country:US
Practice Address - Phone:717-721-4280
Practice Address - Fax:717-207-8905
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426317207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH71969Medicare UPIN
PA192798HK1Medicare PIN
PA1447084OtherPERSONAL CHOICE
PA20045180OtherAMERIHEALTH
PA2246808OtherUNITED HEALTHCARE
PA3960153OtherAETNA HMO
PA1012566950004Medicaid
PA7281389OtherAETNA PPO
PA9255032OtherPHCS
PA091149QCNMedicare PIN
PA7028488OtherCIGNA
PA30022700OtherKEYSTONE MERCY
PA1012566950001Medicaid
PA101256695-01OtherAMERICHOICE
PA35668OtherHEALTH PARTNERS
PAH71969Medicare UPIN
PA1447084OtherHIGHMARK BLUE SHIELD