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Individual

DR. MUJTABA I BUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1465 KINGSLEY AVE, SUITE 1101, ORANGE PARK, FL 32073-4504
(904) 264-9797
(904) 264-4644
Mailing address
4800 BELFORT RD, JACKSONVILLE, FL 32256-6004

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME116837
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003136488B
GA
05
009259400
FL
Enumeration date
10/03/2006
Last updated
09/21/2016
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