Basic Information
| Provider Information | |||||||||
| NPI: | 1215970512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 297 NORTH ST STE 221 | ||||||||
| Address2: | |||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026015133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088627777 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HYANNIS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026013825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087784777 | ||||||||
| FaxNumber: | 5087719555 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 06/17/2019 | ||||||||
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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 | 207Q00000X | MD028269E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200727 | 01 | UPMC HEALTH PLAN | OTHER | P000248 | 01 | GATEWAY HEALTH PLAN | OTHER | 459406 | 01 | BLUE SHIELD | OTHER | 080172833 | 01 | RAILROAD MEDICARE | OTHER | 4308190 | 01 | AETNA | OTHER | 001038183 | 05 | PA | MEDICAID |