Provider Demographics
NPI:1427159581
Name:BUDAI, ROBERT S (MPT, OCS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:BUDAI
Suffix:
Gender:M
Credentials:MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44814 LARKSPUR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1397
Mailing Address - Country:US
Mailing Address - Phone:248-390-8363
Mailing Address - Fax:
Practice Address - Street 1:5210 HIGHLAND RD
Practice Address - Street 2:STE 100
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-1970
Practice Address - Country:US
Practice Address - Phone:248-674-9560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010102872251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI65-0-F3-2760-0OtherBLUE CROSS/BLUE SHIELD
MIN69750053Medicare PIN
MI65-0-F3-2760-0OtherBLUE CROSS/BLUE SHIELD
MIMI6211063Medicare PIN