MEDICARE: MR. STEPHEN ROBERT BUTLER MD

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	2080N0001X	Neonatal-Perinatal Medicine Physician	G41558	CA

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	:	1487646964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN ROBERT BUTLER MD

Provider Business Mailing Address
First Line	:	5301 F STREET
Second Line	:	STE 313
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3222
Country	:	US
Telephone Number	:	916-736-6470
Fax Number	:	916-736-6798

Provider Business Practice Location Address
First Line	:	5151 F STREET 2 SOUTH
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-3222
Country	:	US
Telephone Number	:	916-733-8441
Fax Number	:	916-733-1728

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	07/08/2007

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