Provider Demographics
NPI:1588642342
Name:BUTT, TAIMUR SALAR (MD)
Entity Type:Individual
Prefix:DR
First Name:TAIMUR
Middle Name:SALAR
Last Name:BUTT
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 1:304 BLUE JACKET RD
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-6346
Mailing Address - Country:US
Mailing Address - Phone:567-202-0126
Mailing Address - Fax:
Practice Address - Street 1:145 WEST WALLACE STREET
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-1299
Practice Address - Country:US
Practice Address - Phone:419-423-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH080937207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2119988Medicaid
OH000000550158OtherANTHEM BCBS
OH2119988Medicaid
OHBU7380771Medicare PIN
OHBU4092796Medicare PIN
OHP00435355Medicare PIN