Provider Demographics
NPI:1053370593
Name:BUDDEN, TEMISHA H (PA)
Entity type:Individual
Prefix:MRS
First Name:TEMISHA
Middle Name:H
Last Name:BUDDEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BARNETTE DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-8004
Mailing Address - Country:US
Mailing Address - Phone:803-773-5442
Mailing Address - Fax:803-778-2394
Practice Address - Street 1:12 BARNETTE DR
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-8004
Practice Address - Country:US
Practice Address - Phone:803-773-5442
Practice Address - Fax:803-778-2394
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC745363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC970026509OtherRAILROAD MEDICARE
SC0609PAMedicaid
SC970026509OtherRAILROAD MEDICARE