Provider Demographics
NPI:1598966715
Name:BUTT, QASIM A (MD)
Entity Type:Individual
Prefix:
First Name:QASIM
Middle Name:A
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 1:5575 DTC PKWY
Mailing Address - Street 2:STE 225
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3073
Mailing Address - Country:US
Mailing Address - Phone:303-390-1926
Mailing Address - Fax:866-368-6349
Practice Address - Street 1:105 W 8TH AVE STE 1000
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2327
Practice Address - Country:US
Practice Address - Phone:509-474-4500
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7528207R00000X, 207RN0300X
KS04-46074207R00000X, 208M00000X
WAMD61272007207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX215184701Medicare PIN
TXTXB106935Medicare PIN