Provider Demographics
NPI:1821030321
Name:BUDMAN, MALORIE L (DO)
Entity Type:Individual
Prefix:DR
First Name:MALORIE
Middle Name:L
Last Name:BUDMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7956 VERREE RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19111-2530
Mailing Address - Country:US
Mailing Address - Phone:215-745-7101
Mailing Address - Fax:215-745-0981
Practice Address - Street 1:1001 STERIGERE ST
Practice Address - Street 2:NORRISTOWN STATE HOSPITAL
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-5300
Practice Address - Country:US
Practice Address - Phone:610-313-1000
Practice Address - Fax:610-313-1013
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS 009602L207Q00000X
PAOS009602L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01748722Medicaid
PA054663Q9NMedicare ID - Type Unspecified
PA01748722Medicaid