Provider Demographics
NPI:1699981878
Name:BUDEIR, MOHAMMED H (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:H
Last Name:BUDEIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:VIVACQUA PAVILION 233
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-447-6090
Mailing Address - Fax:610-447-6088
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:VIVACQUA PAVILION, SUITE 233
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-447-6090
Practice Address - Fax:610-447-6088
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031296E2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001233713Medicaid
PA543761Medicare PIN
PA001233713Medicaid