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Individual
ANISH ATUL BUTALA
Active
Individual
ANISH ATUL BUTALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT210439
PA
2085R0203X
Therapeutic Radiology Physician
Primary
MD472450
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
01/15/2015
Last updated
08/27/2021
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