Provider Demographics
NPI:1790945756
Name:BUTTS, MELISSA SUE (DO)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:SUE
Last Name:BUTTS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TELEMED2U
Mailing Address - Street 2:2510 DOUGLAS BLVD SUITE 300
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661
Mailing Address - Country:US
Mailing Address - Phone:855-446-8628
Mailing Address - Fax:
Practice Address - Street 1:2510 DOUGLAS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3302
Practice Address - Country:US
Practice Address - Phone:855-446-8628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A16394207RR0500X
VA0102202593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology