Provider Demographics
NPI:1689161663
Name:BUDA, MORGAN (MD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:BUDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6527
Mailing Address - Country:US
Mailing Address - Phone:423-439-6464
Mailing Address - Fax:423-439-7118
Practice Address - Street 1:917 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6527
Practice Address - Country:US
Practice Address - Phone:423-439-6464
Practice Address - Fax:423-439-7118
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-16
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN72222207Q00000X
MN66354207Q00000X
390200000X
MEMD28155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program