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General NPI Number Information
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NPI Number | 1891050217
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Entity Type | Individual
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Provider Name | JOHN PAUL BUDI DO
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Gender | Male
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 9555 76TH ST
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City | PLEASANT PRAIRIE
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State | WI
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Zip | 53158-1984
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Country | US
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Telephone | 262-577-8202
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Fax |
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Provider Business Mailing Address
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Address Line | 1668 32ND AVE
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City | KENOSHA
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State | WI
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Zip | 53144-3380
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Country | US
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Telephone | 920-419-7703
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.012288
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 72466-21
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License Number State | WI
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