Individual
EDWARD P BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
170 GOVERNORS AVE, LAWRENCE MEMORIAL HOSPITAL, MEDFORD, MA 02155-1643
(781) 306-6264
(781) 306-6267
Mailing address
170 GOVERNORS AVE, LAWRENCE MEMORIAL HOSPITAL, MEDFORD, MA 02155-1643
(781) 306-6264
(781) 306-6267
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
40936
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0111139
—
MA
01
—
040936
TUFTS
MA
01
—
63278
HARVARD PILGRIM
MA
01
—
EO5327
BLUE CROSS LEGACY #
MA
Enumeration date
11/14/2005
Last updated
04/03/2013
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