Provider Demographics
NPI:1083727317
Name:BUTT, ATTA (MD)
Entity Type:Individual
Prefix:
First Name:ATTA
Middle Name:
Last Name:BUTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 MEASE DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695
Mailing Address - Country:US
Mailing Address - Phone:727-330-7652
Mailing Address - Fax:727-330-7655
Practice Address - Street 1:1840 MEASE DR
Practice Address - Street 2:SUITE 402
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695
Practice Address - Country:US
Practice Address - Phone:727-330-7652
Practice Address - Fax:727-330-7655
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 87687207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48221OtherBCBS
FL7599657OtherAETNA
I04340Medicare UPIN
FL7599657OtherAETNA