Provider Demographics
NPI:1467030064
Name:BUTLER, SETH PAUL (DO)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:PAUL
Last Name:BUTLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:77 GOODELL ST STE 340
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1243
Mailing Address - Country:US
Mailing Address - Phone:716-645-9707
Mailing Address - Fax:716-645-9701
Practice Address - Street 1:77 GOODELL ST STE 340
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1243
Practice Address - Country:US
Practice Address - Phone:716-645-9707
Practice Address - Fax:716-645-9701
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY328835207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program