MEDICARE: KUMARASWAMY BUDUR MD

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
1	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	62481	GA
2	2084P0800X	Psychiatry Physician	35083493	OH

General Provider Information

NPI Number	:	1881636140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KUMARASWAMY BUDUR MD

Provider Business Mailing Address
First Line	:	701 S WELLS ST APT 2103
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4631
Country	:	US
Telephone Number	:	440-317-1106
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 S WELLS ST APT 2103
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60607-4631
Country	:	US
Telephone Number	:	440-317-1106
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/18/2020

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