Provider Demographics
NPI:1013357466
Name:S H BUTT MD INC.
Entity Type:Organization
Organization Name:S H BUTT MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHID
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-234-4334
Mailing Address - Street 1:18820 BAGLEY RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3325
Mailing Address - Country:US
Mailing Address - Phone:440-234-4334
Mailing Address - Fax:440-234-4335
Practice Address - Street 1:18820 BAGLEY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3325
Practice Address - Country:US
Practice Address - Phone:440-234-4334
Practice Address - Fax:440-234-4335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-30
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.043284207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0473116Medicaid
OH0473116Medicaid