Provider Demographics
NPI:1821251240
Name:BUDHOO, DAVID JONATHAN (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JONATHAN
Last Name:BUDHOO
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:PO BOX 1711
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-1711
Mailing Address - Country:US
Mailing Address - Phone:864-314-9214
Mailing Address - Fax:
Practice Address - Street 1:123 UPPER VIEW TER
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-6240
Practice Address - Country:US
Practice Address - Phone:843-246-1694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33401207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program