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General NPI Number Information
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NPI Number | 1154385078
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Entity Type | Individual
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Provider Name | MATTHEW P BUTLER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 340 MAPLE STREET SUITE 405
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City | MARLBOROUGH
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State | MA
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Zip | 01752
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Country | US
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Telephone | 617-480-2541
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Fax |
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Provider Business Mailing Address
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Address Line | 1153 CENTRE ST SUITE 5980
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City | BOSTON
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State | MA
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Zip | 02130-3446
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Country | US
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Telephone | 617-983-1900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 2037
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License Number State | MA
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