Basic Information
| Provider Information | |||||||||
| NPI: | 1427159581 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUDAI | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MPT, OCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 44814 LARKSPUR | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483771397 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483908363 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5210 HIGHLAND RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | WATERFORD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483271970 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2486749560 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2006 | ||||||||
| LastUpdateDate: | 10/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 5501010287 | MI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | 225100000X | 5501010287 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 65-0-F3-2760-0 | 01 | MI | BLUE CROSS/BLUE SHIELD | OTHER |