Provider Demographics
NPI:1780687970
Name:BUTT, MUHAMMAD M (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:M
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 1:1100 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-3923
Mailing Address - Country:US
Mailing Address - Phone:785-243-4272
Mailing Address - Fax:785-243-8411
Practice Address - Street 1:1100 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901-3923
Practice Address - Country:US
Practice Address - Phone:785-243-4272
Practice Address - Fax:785-243-8411
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0416276174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00101608OtherRAILROAD MEDICARE
KSP00101608OtherRAILROAD MEDICARE
KS103013Medicare ID - Type UnspecifiedMEDICARE/BCBS