Provider Demographics
NPI:1811351745
Name:BHUTTA, UMMAIR
Entity type:Individual
Prefix:
First Name:UMMAIR
Middle Name:
Last Name:BHUTTA
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 1:406 HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-5708
Mailing Address - Country:US
Mailing Address - Phone:757-874-1245
Mailing Address - Fax:
Practice Address - Street 1:1215 GEORGE WASHINGTON MEM HWY STE D
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23693-4316
Practice Address - Country:US
Practice Address - Phone:757-810-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-06
Last Update Date:2020-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist