Basic Information
| Provider Information | |||||||||
| NPI: | 1164415329 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUDDE | ||||||||
| FirstName: | LEANNE | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4685 FOREST AVE | ||||||||
| Address2: | STE C | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452123397 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138534721 | ||||||||
| FaxNumber: | 5138528525 | ||||||||
| Practice Location | |||||||||
| Address1: | 5520 CHEVIOT RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452477069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134514033 | ||||||||
| FaxNumber: | 5134511356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 02/14/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 35080295 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RX0202X | 01055053A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | 207RH0000X | 35080295 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology |
ID Information
| ID | Type | State | Issuer | Description | 64101280 | 05 | KY | MEDICAID | 2552330 | 05 | OH | MEDICAID | 200507970 | 05 | IN | MEDICAID |