Individual
SHAWN T. BUTELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 KINGSLEY LN, SUITE 305, NORFOLK, VA 23505-4614
(757) 889-5942
(757) 889-5422
Mailing address
110 KINGSLEY LN, SUITE 305, NORFOLK, VA 23505-4614
(757) 889-5942
(757) 889-5422
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A71143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A711430
BLUE SHIELD
CA
05
—
00A711430
—
CA
Enumeration date
06/06/2006
Last updated
11/28/2011
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