Provider Demographics
NPI:1255695896
Name:BUTLER, ANTHONY LAMAR
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:LAMAR
Last Name:BUTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7221 24TH PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-2717
Mailing Address - Country:US
Mailing Address - Phone:202-717-0241
Mailing Address - Fax:
Practice Address - Street 1:7221 24TH PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-2717
Practice Address - Country:US
Practice Address - Phone:202-717-0241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide