Healthcare Provider Details

I. General information

NPI: 1285331694
Provider Name (Legal Business Name): MR. DAVID MICHAEL BUTTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 GALVESTON ST SW APT 204
WASHINGTON DC
20032-1972
US

IV. Provider business mailing address

57 GALVESTON ST SW APT 204
WASHINGTON DC
20032-1972
US

V. Phone/Fax

Practice location:
  • Phone: 202-498-5820
  • Fax:
Mailing address:
  • Phone: 202-498-5820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: