Provider Demographics
NPI:1437751112
Name:BUTIA, TITUS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TITUS
Middle Name:
Last Name:BUTIA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5740 UNION MILL RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-1088
Mailing Address - Country:US
Mailing Address - Phone:703-818-0589
Mailing Address - Fax:
Practice Address - Street 1:5740 UNION MILL RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-1088
Practice Address - Country:US
Practice Address - Phone:703-818-0589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist