Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0053290 | MD |
N | 2080A0000X | Adolescent Medicine | D0053290 | MD |
NPI | 1104881200 |
---|---|
Provider Name | Dr. Atchuthanand Budi |
First Address | Hagerstown, MD 21740 |
Second Address | Hagerstown, MD 21740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 26/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
552300100 | (05) | MD |
G86075 | (02) | MD |