Healthcare Provider Details

I. General information

NPI: 1962330837
Provider Name (Legal Business Name): MILAN BUTLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5352 THOMAS ST
MAPLE HEIGHTS OH
44137-2625
US

IV. Provider business mailing address

5352 THOMAS ST
MAPLE HEIGHTS OH
44137-2625
US

V. Phone/Fax

Practice location:
  • Phone: 216-322-6995
  • Fax:
Mailing address:
  • Phone: 216-322-6995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberAPRN.CNP.0042089
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: