Individual
DR. JONI SUE OVANNA BUDHRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 MEDICAL PARK DR, SUITE 108, HARTSVILLE, SC 29550-4777
(843) 332-6645
(843) 332-9229
Mailing address
701 MEDICAL PARK DR, STE 108, HARTSVILLE, SC 29550-4777
(843) 332-6645
(843) 332-9894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28451
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28451
SC LICENSE NUMBER
SC
Enumeration date
01/02/2007
Last updated
03/07/2011
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