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General NPI Number Information
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NPI Number | 1952755951
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Entity Type | Individual
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Provider Name | BRADLEY JOSEPH BUDDE MD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2016
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 4700 MEMORIAL DR DIV WUPI NEUROSURGERY, STE 230
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City | BELLEVILLE
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State | IL
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Zip | 62226-5373
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Country | US
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Telephone | 618-212-6620
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Fax | 618-212-6621
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Provider Business Mailing Address
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Address Line | PO BOX 7412011
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 618-212-6620
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Fax | 618-212-6621
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 036170326
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License Number State | IL
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