Provider Demographics
NPI:1982660304
Name:BUDIN, MICHAEL M (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:BUDIN
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 1:438 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820
Mailing Address - Country:US
Mailing Address - Phone:607-432-5563
Mailing Address - Fax:607-432-2437
Practice Address - Street 1:438 MAIN ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820
Practice Address - Country:US
Practice Address - Phone:607-432-5563
Practice Address - Fax:607-432-2437
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169632208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
248001OtherMVP VENDOR NUMBER
24811OtherMVP VENDOR NUMBER
NY01226219Medicaid
5671OtherCDPHP GROUP NUMBER
000000026311OtherGHI HMO
126311OtherWELLCARE
169632OtherNYS LICENSE
340004206OtherRR MEDICARE
MB054T7210OtherDOWN MEDICARE
222694570OtherTAX ID
9599758OtherGHI PPO
BB1667Medicare ID - Type Unspecified
NY01226219Medicaid