MEDICARE: DR. DAVID ALEXANDER BUTMAN PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1417437856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALEXANDER BUTMAN PSY.D.

Provider Business Mailing Address
First Line	:	85 OLD EAGLE SCHOOL RD STE 200
Second Line	:
City	:	STRAFFORD
State	:	PA
Zip	:	19087-2564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	85 OLD EAGLE SCHOOL RD STE 200
Second Line	:
City	:	STRAFFORD
State	:	PA
Zip	:	19087-2564
Country	:	US
Telephone Number	:	267-418-5109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2018
Last Update Date	:	08/15/2018

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