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Individual

DR. MARY BUDKE

Active
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Individual

DR. MARY BUDKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD 12915
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
067509
OR
01
104892
WA L & I
05
8279986
WA
01
A021
CHAMPUS
01
E97248
PROVIDENCE
05
XPY188093
CA
Enumeration date
06/19/2006
Last updated
12/19/2007
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