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General NPI Number Information
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NPI Number | 1275871485
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Entity Type | Individual
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Provider Name | AHMAR MANNAN BUTT M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 1517 N ANKENY BLVD STE E
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City | ANKENY
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State | IA
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Zip | 50023-4120
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Country | US
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Telephone | 515-337-3967
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Fax | 800-861-7495
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Provider Business Mailing Address
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Address Line | 520 SPYGLASS CT
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City | WAUKEE
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State | IA
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Zip | 50263-8061
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Country | US
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Telephone | 814-720-5669
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Fax | 515-282-8090
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | MD-42473
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 272034
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD-42473
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD-42473
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License Number State | IA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD-42473
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License Number State | IA
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