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Individual

ABIDA B. BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
HSC, T16 020, STONY BROOK, NY 11794-8160
(631) 444-8478
(631) 444-7546
Mailing address
PO BOX 1554, STONY BROOK, NY 11790-0988
(631) 444-0650
(631) 638-4170

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11514R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00124691
MS
05
1669962
LA
01
G6438
BLUECROSS BLUESHIELD
LA
01
P00803002
RRMCARE THRU HCCN
MS
Enumeration date
01/16/2006
Last updated
02/17/2017
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