Healthcare Provider Details
I. General information
NPI: 1568445526
Provider Name (Legal Business Name): AMY E BUTLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/23/2005
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
544 E STUART DR STE D
GALAX VA
24333-2231
US
IV. Provider business mailing address
213 S JEFFERSON ST STE 1006
ROANOKE VA
24011-1713
US
V. Phone/Fax
- Phone: 276-236-6136
- Fax: 276-236-2536
- Phone: 540-224-5516
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 0101232843 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101-232843 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: