MEDICARE: DAN STEFAN BUTOI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD038649L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326043589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN STEFAN BUTOI M.D.

Provider Business Mailing Address
First Line	:	500 FOWLER AVE
Second Line	:	STE 202
City	:	BERWICK
State	:	PA
Zip	:	18603-3326
Country	:	US
Telephone Number	:	570-752-2349
Fax Number	:	570-752-6959

Provider Business Practice Location Address
First Line	:	500 FOWLER AVE
Second Line	:	STE 202
City	:	BERWICK
State	:	PA
Zip	:	18603-3326
Country	:	US
Telephone Number	:	570-752-2349
Fax Number	:	570-752-6959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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Directions to “ DAN STEFAN BUTOI M.D.” Practice Location

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