Healthcare Provider Details

I. General information

NPI: 1912359506
Provider Name (Legal Business Name): ATIF BUTT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

IV. Provider business mailing address

PO BOX 417
WHITE SULPHUR SPRINGS WV
24986-0417
US

V. Phone/Fax

Practice location:
  • Phone: 252-816-2273
  • Fax: 252-816-2657
Mailing address:
  • Phone: 304-536-5030
  • Fax: 304-536-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28836
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number320489
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: