Provider Demographics
NPI:1295727642
Name:BUDMAN, ALAN D (DPM)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:D
Last Name:BUDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E SOMERDALE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1107
Mailing Address - Country:US
Mailing Address - Phone:856-783-2800
Mailing Address - Fax:856-783-7669
Practice Address - Street 1:301 E SOMERDALE RD
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-1107
Practice Address - Country:US
Practice Address - Phone:856-783-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00120100213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0347604Medicaid
NJT44690Medicare UPIN
NJ093100Medicare ID - Type Unspecified
NJ0324140002Medicare NSC