Provider Demographics
NPI:1982693628
Name:BUTLER, DAVID PAUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PAUL
Last Name:BUTLER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BROWN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5714
Mailing Address - Country:US
Mailing Address - Phone:207-240-1716
Mailing Address - Fax:207-753-0503
Practice Address - Street 1:61 UNION ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-5475
Practice Address - Country:US
Practice Address - Phone:207-753-0102
Practice Address - Fax:207-753-0503
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4043183500000X, 1835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support