Basic Information
Provider Information
NPI: 1306058557
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUTLER
FirstName: MICHAEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 930 FRANKLIN ST SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014312
CountryCode: US
TelephoneNumber: 2565394080
FaxNumber:  
Practice Location
Address1: 930 FRANKLIN ST SE
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358014312
CountryCode: US
TelephoneNumber: 2565394080
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/03/2007
LastUpdateDate: 05/09/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XMD.28379ALN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011XMD.28379ALY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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