Organization
DAVID J BUTUK MD PA
Active
Other names
MERIDIAN FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J BUTUK M.D. (OWNER)
(208) 888-1199
Entity
Organization
Contact information
Practice address
1525 E LEIGHFIELD DR, SUITE 150, MERIDIAN, ID 83646-5371
(208) 888-1199
(208) 888-0807
Mailing address
PO BOX 44440, BOISE, ID 83711-0440
(208) 888-1199
(208) 888-0807
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806698100
—
ID
Enumeration date
10/02/2007
Last updated
10/02/2007
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