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PRAVEEN BUDDE MD
>> Specialist >> Other Service ProvidersRegistrant NPI Number: 1679808638
Individual Registrant: PRAVEEN BUDDE MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
909 E RAILROAD AVE FORT MORGAN, CO 80701-3301 US
Tel: 970-542-4700 Fax: --
Tel: 970-542-4700 Fax: --
Contact information for business:
909 E. RAIL ROAD BANNER HEALTH FORT MORGAN, CO 80701 US
Tel: 970-542-4700 Fax: --
Tel: 970-542-4700 Fax: --
Registration Information:
NPI: 1679808638
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 174400000X | Other Service Providers Specialist | CO | DR51457 |
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | LA | MD.207797 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
