Healthcare Provider Details

I. General information

NPI: 1275809311
Provider Name (Legal Business Name): EMMARY SAMEL BUTLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US

IV. Provider business mailing address

625 34TH ST STE 100&200
BAKERSFIELD CA
93301-2305
US

V. Phone/Fax

Practice location:
  • Phone: 833-678-2781
  • Fax: 661-368-0618
Mailing address:
  • Phone: 833-678-2781
  • Fax: 661-368-0618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC204555
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD492056C
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01075064A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: