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Individual

DIANE ARLENE BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6681 RIDGE RD, #205, PARMA, OH 44129-5713
(440) 842-1121
(440) 842-5676
Mailing address
6681 RIDGE RD, #205, PARMA, OH 44129-5713
(440) 842-1121
(440) 842-5676

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35043685
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000139981
ANTHEM
OH
05
0692880
OH
01
341834105031
CARE SOURCE
OH
Enumeration date
05/03/2006
Last updated
04/18/2013
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