Provider Demographics
NPI:1336221183
Name:BUDINETZ, ROBERT E (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:BUDINETZ
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 1:801 OSTRUM ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:332-136-4288
Practice Address - Street 1:9 DAVES WAY
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-1413
Practice Address - Country:US
Practice Address - Phone:610-628-7206
Practice Address - Fax:833-214-7522
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD426374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014113080001Medicaid
PA50056902OtherCAPITAL BLUE SHIELD
PA1783231OtherHIGHMARK BLUE SHIELD
PAP00288501OtherPALMETTO RR
PA50056902OtherCAPITAL BLUE SHIELD
PAP00288501OtherPALMETTO RR