Provider Demographics
NPI:1508926106
Name:BUTLER, CHARLES FRANCIS (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANCIS
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2130 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-3657
Mailing Address - Country:US
Mailing Address - Phone:269-598-6000
Mailing Address - Fax:269-388-9000
Practice Address - Street 1:2130 S PARK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-3657
Practice Address - Country:US
Practice Address - Phone:269-598-6000
Practice Address - Fax:269-388-5555
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301044368208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
A74753Medicare UPIN