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Individual

ANKUR BUTALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
600 N WOLFE ST, MEYER 6-181, BALTIMORE, MD 21287-0005
(410) 502-0133
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
274204
NY
2084N0400X
Neurology Physician
Primary
D79589
MD
2084P0800X
Psychiatry Physician
274204
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03983979
NY
Enumeration date
06/11/2008
Last updated
02/12/2024
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