Provider Demographics
NPI:1912940735
Name:BUDEV EYECARE & SURGERY, PA
Entity type:Organization
Organization Name:BUDEV EYECARE & SURGERY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MILLIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUDEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-763-5151
Mailing Address - Street 1:2093 HENRY TECKLENBURG DRIVE
Mailing Address - Street 2:STE 313
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414
Mailing Address - Country:US
Mailing Address - Phone:843-763-5151
Mailing Address - Fax:
Practice Address - Street 1:2093 HENRY TECKLENBURG DRIVE
Practice Address - Street 2:STE 313
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414
Practice Address - Country:US
Practice Address - Phone:843-763-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21896207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty