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General NPI Number Information
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NPI Number | 1992910608
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Entity Type | Organization
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Legal Business Name | JERRY MICHAEL BUTTO DO PC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5400 FORT ST SUITE 250
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City | TRENTON
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State | MI
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Zip | 48183-4632
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Country | US
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Telephone | 734-671-8500
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Fax | 734-671-8503
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Provider Business Mailing Address
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Address Line | 5400 FORT ST SUITE 250
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City | TRENTON
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State | MI
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Zip | 48183-4632
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Country | US
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Telephone | 734-671-8500
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Fax | 734-671-8503
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRY MICHAEL BUTTO
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Credential | D.O.
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Telephone | 734-671-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Obstetrics & Gynecology) Physician
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License Number | JB012712
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License Number State | MI
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