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General NPI Number Information
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NPI Number | 1689384802
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Entity Type | Individual
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Provider Name | MICHAEL ALEXANDER BUDJAK DC
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Gender | Male
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 4000 ENTERPRISE DR
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City | SHEBOYGAN
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State | WI
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Zip | 53083-2245
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Country | US
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Telephone | 920-459-9090
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Fax | 920-459-7426
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Provider Business Mailing Address
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Address Line | 11009 N CEDARBURG RD
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City | MEQUON
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State | WI
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Zip | 53092-4305
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Country | US
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Telephone | 563-549-2015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 6037-12
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License Number State | WI
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