Provider Demographics
NPI:1275594970
Name:BUTRUS, SALIM I (MD)
Entity Type:Individual
Prefix:
First Name:SALIM
Middle Name:I
Last Name:BUTRUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 PENNSYLVANIA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4318
Mailing Address - Country:US
Mailing Address - Phone:202-544-1900
Mailing Address - Fax:202-547-4257
Practice Address - Street 1:650 PENNSYLVANIA AVE SE
Practice Address - Street 2:SUITE 270
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4318
Practice Address - Country:US
Practice Address - Phone:202-544-1900
Practice Address - Fax:202-547-4257
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD 18998207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
207W00000XOtherTAXONOMY
DCG02113Medicare PIN
207W00000XOtherTAXONOMY