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NPI Code Detail

MEDICARE: STEPHEN BUDD

MEDICARE:   STEPHEN  BUDD
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1639981459
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN BUDD
Provider Business Mailing Address
First Line : 1014 W 36TH ST STE 656
Second Line :
City : BALTIMORE
State : MD
Zip : 21211-2415
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2287 HENRY TECKLENBURG DR STE 2
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-7811
Country : US
Telephone Number : 843-974-5622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2025
Last Update Date : 12/01/2025

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Directions to “ STEPHEN BUDD ” Practice Location

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