Provider Demographics
NPI:1962440701
Name:BUTLER, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:BUTLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:603-2 N PROGRESS AVE STE 400
Mailing Address - Street 2:SILOAM SPRINGS CARDIOLOGY
Mailing Address - City:SILOAM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72761-4401
Mailing Address - Country:US
Mailing Address - Phone:479-215-3060
Mailing Address - Fax:479-549-4044
Practice Address - Street 1:603-2 N PROGRESS AVE STE 400
Practice Address - Street 2:SILOAM SPRINGS CARDIOLOGY
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-4401
Practice Address - Country:US
Practice Address - Phone:479-215-3060
Practice Address - Fax:479-549-4044
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2014-03-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05045100207RC0000X
ARE-7929207RC0000X
OK30125207RC0000X
NC9701266207RC0000X
VA0101050127207RC0000X
PAMD044769E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
60022220OtherHORIZON NJ HEALTH
001007591OtherAMERICHOICE
NJ0013846Medicaid
3K5951OtherHEALTHNET
P00390944OtherRR MEDICARE
42419OtherUNIVERSITY HEALTHPLAN
1168522OtherAETNA
P3722693OtherOXFORD
2341853OtherUNITED HEALTHCARE
PA955491OtherPA BLUE SHIELD
P3722693OtherOXFORD
NJF44178Medicare UPIN