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NPI Code Detail

MEDICARE: JOHN BUDDENHAGEN DO

MEDICARE: JOHN BUDDENHAGEN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician281604NY

General Provider Information

NPI Number : 1598103822
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN BUDDENHAGEN DO
Provider Business Mailing Address
First Line : 407 ALBANY SHAKER RD
Second Line :
City : LOUDONVILLE
State : NY
Zip : 12211-1900
Country : US
Telephone Number : 518-435-1300
Fax Number : 518-435-1397
Provider Business Practice Location Address
First Line : 407 ALBANY SHAKER RD
Second Line :
City : LOUDONVILLE
State : NY
Zip : 12211-1900
Country : US
Telephone Number : 518-435-1300
Fax Number : 518-435-1397
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2013
Last Update Date : 01/29/2019

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