Provider Demographics
NPI:1295884740
Name:BUTTAR, DALJIT SINGH (MD)
Entity type:Individual
Prefix:
First Name:DALJIT
Middle Name:SINGH
Last Name:BUTTAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4201 LAKE BOONE TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-7512
Mailing Address - Country:US
Mailing Address - Phone:919-510-0688
Mailing Address - Fax:919-863-0257
Practice Address - Street 1:4201 LAKE BOONE TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-7512
Practice Address - Country:US
Practice Address - Phone:919-510-0688
Practice Address - Fax:919-863-0257
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2013-07-10
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Provider Licenses
StateLicense IDTaxonomies
NC31714208VP0014X, 208VP0000X, 2084N0600X, 2084N0400X, 2084N0008X, 2084P2900X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8920466Medicaid
NC8920466Medicaid
NC213560KMedicare PIN