1932136934 NPI number — DR. HAMEED AHMAD BUTT MD

Table of content: DR. HAMEED AHMAD BUTT MD (NPI 1932136934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932136934 NPI number — DR. HAMEED AHMAD BUTT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUTT
Provider First Name:
HAMEED
Provider Middle Name:
AHMAD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932136934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1111 E END BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILKES BARRE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18711-0030
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-824-3521
Provider Business Mailing Address Fax Number:
570-288-8065

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
50 MOISEY DRIVE, SUITE 214
Provider Second Line Business Practice Location Address:
HEALTH AND WELLNESS CENTER
Provider Business Practice Location Address City Name:
HAZLETON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-501-6900
Provider Business Practice Location Address Fax Number:
570-501-6945
Provider Enumeration Date:
06/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD034609L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0005868440002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com