Provider Demographics
NPI:1760036776
Name:BUTZEN, MICHAEL RAYMOND (DNP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:RAYMOND
Last Name:BUTZEN
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Gender:M
Credentials:DNP
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Mailing Address - Street 1:5400 LAUREL SPRINGS PKWY STE 1404
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6098
Mailing Address - Country:US
Mailing Address - Phone:678-347-2153
Mailing Address - Fax:678-680-5147
Practice Address - Street 1:3625 BRASELTON HWY STE 104
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-4696
Practice Address - Country:US
Practice Address - Phone:678-347-2153
Practice Address - Fax:678-928-4722
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2022-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN250536363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care