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General NPI Number Information
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NPI Number | 1427686757
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Entity Type | Individual
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Provider Name | DEMARIO MONTEZ BUTTS MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 500 UPPER CHESAPEAKE DR
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City | BEL AIR
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State | MD
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Zip | 21014-4324
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Country | US
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Telephone | 443-643-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 16001 W 9 MILE RD FL 1
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4818
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Country | US
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Telephone | 404-290-7898
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 4301507204
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301507204
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License Number State | MI
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