Provider Demographics
NPI:1003896721
Name:CONCORD CARDIOLOGY
Entity Type:Organization
Organization Name:CONCORD CARDIOLOGY
Other - Org Name:ANJUM BUTTE MD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANJUM
Authorized Official - Middle Name:N
Authorized Official - Last Name:BUTTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-287-0021
Mailing Address - Street 1:131 OLD ROAD TO NINE ACRE CORNER
Mailing Address - Street 2:SUITE 520 JOHN CUMING BLDG
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742
Mailing Address - Country:US
Mailing Address - Phone:978-287-0021
Mailing Address - Fax:978-287-0155
Practice Address - Street 1:131 OLD ROAD TO NINE ACRE CORNER
Practice Address - Street 2:SUITE 520 JOHN CUMING BLDG
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742
Practice Address - Country:US
Practice Address - Phone:978-287-0021
Practice Address - Fax:978-287-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3175600Medicaid
A21214Medicare ID - Type Unspecified
MA3175600Medicaid