Provider Demographics
NPI:1881110294
Name:DAVID BUDHOO, LLC
Entity type:Organization
Organization Name:DAVID BUDHOO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:BUDHOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-246-1694
Mailing Address - Street 1:PO BOX 1711
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-1711
Mailing Address - Country:US
Mailing Address - Phone:864-314-9214
Mailing Address - Fax:
Practice Address - Street 1:123 UPPER VIEW TER
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-6240
Practice Address - Country:US
Practice Address - Phone:864-314-9214
Practice Address - Fax:864-207-7526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33401207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty