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Individual

DR. MICHAEL JOHN BUTCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
3900 PARK NICOLLET BLVD, SAINT LOUIS PARK, MN 55416-2503
(952) 993-1000
Mailing address
8170 33RD AVE S, PO BOX 1309 MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
036-134467
IL
208800000X
Urology Physician
Primary
59342
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036134467
IL
Enumeration date
03/01/2009
Last updated
03/09/2016
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