| David Budhoo, Llc | |
|
123 Upper View Ter Anderson SC 29625-6240 | |
| (864) 314-9214 | |
| (864) 207-7526 |
| Full Name | David Budhoo, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 123 Upper View Ter, Anderson, South Carolina |
| Authorized Official Name and Position | David Jonathan Budhoo (PRESIDENT) |
| Authorized Official Contact | 8432461694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Budhoo, Llc Po Box 1711 Anderson SC 29622-1711 Ph: (864) 314-9214 | David Budhoo, Llc 123 Upper View Ter Anderson SC 29625-6240 Ph: (864) 314-9214 |
| NPI Number | 1881110294 |
|---|---|
| Provider Enumeration Date | 08/17/2017 |
| Last Update Date | 03/18/2024 |
| Medicare PECOS PAC ID | 5496088684 |
|---|---|
| Medicare Enrollment ID | O20190603001233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881110294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 33401 (South Carolina) | Primary |
| Provider Name | David Jonathan Budhoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821251240 PECOS PAC ID: 1951579374 Enrollment ID: I20110729000135 |
| Provider Name | Peter L Zervos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619111804 PECOS PAC ID: 0446415194 Enrollment ID: I20141113001813 |
| Provider Name | Kandy Stevenson-black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922564889 PECOS PAC ID: 9436483013 Enrollment ID: I20190702001432 |
| Provider Name | Cortney Shantres Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396380283 PECOS PAC ID: 3870904162 Enrollment ID: I20201117001721 |
| Provider Name | Andrika Godfrey Bluford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710569744 PECOS PAC ID: 1850791393 Enrollment ID: I20210621001810 |
| Provider Name | Jessica Mitchell Simpkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699444000 PECOS PAC ID: 5890184535 Enrollment ID: I20211117003089 |
| Provider Name | Christian Alexendria Dicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710661095 PECOS PAC ID: 6800259615 Enrollment ID: I20230828000737 |
| Provider Name | Erin Pruitt Drennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821855602 PECOS PAC ID: 3870930993 Enrollment ID: I20240326000488 |
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