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General NPI Number Information
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NPI Number | 1609967652
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Entity Type | Organization
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Legal Business Name | BUTCHBAKER FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 235 E CHICAGO ST STE 2
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City | COLDWATER
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State | MI
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Zip | 49036-1789
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Country | US
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Telephone | 517-278-6411
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Fax | 517-278-4331
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Provider Business Mailing Address
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Address Line | 235 E CHICAGO ST STE 2
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City | COLDWATER
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State | MI
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Zip | 49036-1789
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Country | US
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Telephone | 517-278-6411
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Fax | 517-278-4331
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Authorized Official
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Title or Position | OWNER PHYSICAN
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Name | DR. ANGELA KAYE BUTCHBAKER
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Credential | D.O.
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Telephone | 517-278-6411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101013510
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License Number State | MI
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