Provider Demographics
NPI:1336563519
Name:BUDZYN, MATTHEW (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BUDZYN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:
Other - Last Name:BUDZYN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:804 PIKE ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3503
Mailing Address - Country:US
Mailing Address - Phone:740-376-9035
Mailing Address - Fax:740-376-9037
Practice Address - Street 1:804 PIKE ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3503
Practice Address - Country:US
Practice Address - Phone:740-376-9035
Practice Address - Fax:740-376-9037
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12663183500000X
OH33375183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist