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NPI Code Detail

MEDICARE: DR. JOHN GRANT BUTTRAM JR. M.D.

MEDICARE: DR. JOHN GRANT BUTTRAM JR. M.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
1207T00000XNeurological Surgery Physician2008-00514NC

General Provider Information

NPI Number : 1801019781
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN GRANT BUTTRAM JR. M.D.
Provider Business Mailing Address
First Line : 4207 LAKE BOONE TRL STE 220
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6685
Country : US
Telephone Number : 919-784-1410
Fax Number : 919-784-1409
Provider Business Practice Location Address
First Line : 4207 LAKE BOONE TRL STE 220
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6685
Country : US
Telephone Number : 919-784-1410
Fax Number : 919-784-1409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2007
Last Update Date : 02/22/2021

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