Provider Demographics
NPI:1023442548
Name:BUDINGER, MIRIAM DEARBORN (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:DEARBORN
Last Name:BUDINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94708-1436
Mailing Address - Country:US
Mailing Address - Phone:510-527-5623
Mailing Address - Fax:
Practice Address - Street 1:966 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94708-1436
Practice Address - Country:US
Practice Address - Phone:510-527-5623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23921208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics