Provider Demographics
NPI:1801019781
Name:BUTTRAM, JOHN GRANT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GRANT
Last Name:BUTTRAM
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4207 LAKE BOONE TRL STE 220
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6685
Mailing Address - Country:US
Mailing Address - Phone:919-784-1410
Mailing Address - Fax:919-784-1409
Practice Address - Street 1:4207 LAKE BOONE TRL STE 220
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6685
Practice Address - Country:US
Practice Address - Phone:919-784-1410
Practice Address - Fax:919-784-1409
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-02-22
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2008-00514207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery