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General NPI Number Information
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NPI Number | 1215924667
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Entity Type | Individual
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Provider Name | AMJAD I BUTT MD
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 101 PARK PL
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City | SELMA
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State | AL
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Zip | 36701-6764
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Country | US
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Telephone | 334-526-2200
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Fax | 334-526-2220
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Provider Business Mailing Address
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Address Line | 101 PARK PL
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City | SELMA
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State | AL
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Zip | 36701-6764
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Country | US
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Telephone | 334-526-2200
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Fax | 334-526-2220
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 38037
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License Number State | TN
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